Boosting Treatment Adherence Among Tuberculosis Patients: Evaluating The Efficacy Of Self-Management Training Program

Abstract

Introduction: Tuberculosis (TB) remains a pressing global health challenge, with India bearing the highest burden. Although anti-tuberculosis treatment (ATT) is available under the National Tuberculosis Elimination Program (NTEP), adherence remains suboptimal due to socioeconomic barriers, stigma, and limited patient support. Effective self-management is crucial for treatment adherence and successful TB control. This study aimed to evaluate the effectiveness of a structured self-management training program in improving motivation and knowledge related to treatment adherence among TB patients in India.

Methods: A quasi-experimental, non-equivalent pretest-posttest control group design was employed. A total of 260 TB patients receiving treatment under DOTS at two centers in Patna, Bihar, were selected using purposive sampling. Participants were divided into experimental (n=130) and control (n=130) groups. The experimental group received a six-week structured self-management training program, while the control group received standard care. The Modified Morisky Scale (MMS) was used to measure motivation and knowledge related to adherence. Data were analyzed using non-parametric tests due to lack of normality.

Results: At baseline, both groups showed no significant differences in motivation and knowledge (p>0.05). Post-intervention analysis revealed a significant increase in the experimental group’s motivation (mean: 2.73) and knowledge (mean: 2.92) compared to pretest scores (0.51 and 0.78 respectively), with p-values <0.01. The control group showed no significant change (motivation: p=0.46; knowledge: p=0.66).

Discussion: The findings demonstrate that structured self-management training significantly enhances motivation and knowledge regarding TB treatment adherence. This approach is especially valuable in resource-constrained settings where traditional methods like DOT have limitations.