Improved treatment completion for tuberculosis patients: The case for a dedicated social care team |
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Authors: | Abigail Izzard Sue Wilders Colette Smith Madeleine Wickers Trevor Hart Josiane Dos Santos Helen Booth Dean Creer Ian Cropley Stefan Lozewicz Jacqui White Marc Lipman |
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Affiliation: | 1. North Central London Tuberculosis Service, Whittington Hospital NHS Trust, London United Kingdom;2. University College London, London United Kingdom;3. UCL Respiratory, University College London, London United Kingdom;4. Department of Respiratory Medicine, Royal Free London NHS Foundation Trust, London United Kingdom;5. Department of Infectious Diseases, Royal Free London NHS Foundation Trust, London United Kingdom;6. Department of Respiratory Medicine, North Middlesex University Hospital NHS Trust, London United Kingdom |
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Abstract: | ObjectivesThe increasing social needs of people with Tuberculosis (TB), and the poor adherence to anti-TB therapy (ATT) associated with homelessness, drug or alcohol abuse, and prison history, led us to introduce a social care team (SCT) to support patient engagement with care within this low TB incidence setting.MethodsUsing a risk assessment, patients with social risk factors (SRF) for non-adherence to ATT are identified and a referral made to the SCT, who then provide intensive casework support for areas including homelessness, housing, benefits, debt and immigration. Retrospective data analysis of the social care database from 2017 to 2019 was conducted. Patients who were (n = 170) and were not referred to the SCT (n = 734) were compared.ResultsPatients referred were significantly more likely to complete treatment for TB than those not (88.2% versus 77.7% respectively, p = 0.0025), irrespective of receipt of Directly/Video Observed Therapy and adjusting for confounders.ConclusionsThis paper demonstrates important evidence for the positive impact of a dedicated SCT within a TB service, and these improved treatment outcomes provide a strong argument for development of similar SCTs within UK TB services and similar healthcare settings. |
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