Br J Nurs. 2022 Jul 7;31(13):680-689. doi: 10.12968/bjon.2022.31.13.680.
AIM: To understand patients' perceptions and experiences of directly observed therapy (DOT) for tuberculosis treatment in the UK.
METHOD: Patients receiving DOT as part of their TB treatment participated in semi-structured and audio-recorded interviews. Data were analysed using a framework approach.
RESULTS: Non-adherence was driven by socio-cultural, mental health, employment and discrimination factors. Patients valued DOT for its support and social connection but those in employment feared it could lead to disclosure and social discredit.
CONCLUSION: TB patients experience social isolation and fear discrimination. DOT offers a degree of social connection and support for marginalised patients but fails to tackle fundamental barriers to adherence such as mental health issues, addictions, housing and discrimination. Practice implications: Flexible patient-centred methods of DOT should be offered throughout patients' treatment. Research into multi-agency responsibility for promoting adherence needs to be commissioned, implemented and evaluated. Telemedicine and nurse-led clinics may improve access to care and improve patient experience.
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