Factors associated with a clinician's decision to stop anti-tuberculosis treatment before completion

Chen Yuan Chiang, D. A. Enarson, K. J. Bai, J. Suo, Y. C. Wu, T. P. Lin, K. T. Luh

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

OBJECTIVES: To investigate the diagnosis of pulmonary tuberculosis (PTB) and factors associated with a clinician's decision to stop anti-tuberculosis treatment before completion. DESIGN: The medical charts of all citizens of Taipei City, Taiwan, reported to have received treatment for PTB in 2003 were investigated. RESULTS: Of 1126 PTB patients, 512 (45.5%) started treatment immediately based solely on chest X-ray (CXR) findings; treatment for 214 (19.0%) was based on a positive sputum smear for acid-fast bacilli, for 261 (23.2%) it was based on other findings and for 139 (12.3%) it was based on a positive mycobacterial culture. Of the 1126 PTB patients, 156 (13.9%) had their diagnosis of TB changed by a clinician. Multivariate analysis shows that patients whose diagnosis was based on CXR or other findings, female patients, patients who interrupted treatment for 2 months, patients who continued care at other health facilities (transfer) and patients with lung cancer were significantly more likely to have their diagnosis changed than other groups. CONCLUSION: A substantial proportion of patients were prescribed anti-tuberculosis treatment based on CXR findings alone, and a considerable proportion were advised to stop treatment before completing a full course, findings that require the immediate attention of Taiwan's National Tuberculosis Programme.

Original languageEnglish
Pages (from-to)441-446
Number of pages6
JournalInternational Journal of Tuberculosis and Lung Disease
Volume12
Issue number4
Publication statusPublished - Apr 2008
Externally publishedYes

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Keywords

  • Diagnosis
  • Taiwan
  • Treatment
  • Tuberculosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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