An Evaluation of Medication Adherence in New Tuberculosis Cases in Ankara: A Prospective Cohort Study

Abstract

Background/Objectives: The objective of this study was to investigate the factors influencing adherence with tuberculosis medication therapy. Non-adherence can result in treatment failure, ongoing infectiousness, and the development of drug resistance. Therefore, understanding the reasons behind non-adherence is crucial for achieving the World Health Organization’s target of 90% treatment success. Methods: Data were collected prospectively from a cohort at three different tuberculosis dispensaries (TBDs), with participants being followed up with at face-to-face visits every two months for a total of three visits. Results: In this study, the adherence rates among participants were the highest during the intensive treatment phase (81.0% at the first follow-up) but declined during the continuation phase, reaching 69.4% at the second follow-up (at the end of the fourth month of treatment) and 71.1% at the third follow-up (at the end of the sixth month of treatment) according to self-reports for the past 30 days. According to the generalised estimating equations method, factors significantly associated with better adherence included knowledge of infectiousness, daily access to medication, workplace permissions, high household income, regular sleep patterns, extrapulmonary TB, secondary education, and no alcohol consumption. Conclusions: Non-adherence with anti-TB medication has been observed in patients with TB, particularly during the continuation phase of treatment. Interventions targeting patients who experience frequent forgetfulness, adverse drug reactions, or a lack of workplace flexibility may help to improve adherence. In addition, providing personalised health education that highlights the risks of non-adherence and emphasises the infectious nature of TB could improve understanding and commitment to treatment. Ensuring regular follow-ups and support, particularly for those with lower socioeconomic status or limited social support, can further reinforce the importance of adherence in TB treatment outcomes.