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Article ; Online: Patient-centered approach to the management of drug-resistant tuberculosis in France

Yousra Kherabi / Bastien Mollo / Sandrine Gerard / François-Xavier Lescure / Christophe Rioux / Yazdan Yazdanpanah

PLOS Global Public Health, Vol 2, Iss 4, p e

How far off the mark are we?

2022  Volume 0000313

Abstract: Drug-resistant tuberculosis (DR-TB) is a major public health concern worldwide. The prolonged isolation required is a source of challenges for both healthcare workers and patients, especially in high-income countries where DR-TB patients are frequently ... ...

Abstract Drug-resistant tuberculosis (DR-TB) is a major public health concern worldwide. The prolonged isolation required is a source of challenges for both healthcare workers and patients, especially in high-income countries where DR-TB patients are frequently migrants with vulnerabilities. However, data on the needs of these vulnerable patients are scarce. Our objective was to identify and quantify conflict or inappropriate care situations experienced by both DR-TB patients and healthcare workers. This 10-year retrospective observational study (01/2008 to 10/2018) was conducted in a referral center for resistant tuberculosis management in Paris, France. Sixty-five DR-TB patients were hospitalized during the study period. Their demographic, clinical and social characteristics and any conflict or inappropriate care situations they experienced with healthcare workers while hospitalized were analyzed. Conflict or inappropriate care situations with healthcare workers were reported for 24 patients during their stay (36.9%). Eleven patients (16.9%) had difficulty adhering to respiratory isolation rules, 15 (23.1%) were discharged against medical advice, 9 (13.8%) were excluded from hospital for disciplinary reasons, verbal or physical violence was reported for 7 patients (10.8%), and 4 arrests (6.2%) were made by the police. Conflict situations were reported more often when there was a language barrier (70.8%, p<0.0001). More than one-third of patients with DR-TB in this referral center experienced at least one inappropriate care situation with healthcare workers. This study illustrates the urgent need to promote a patient-centered approach and to respond to the challenges of its practical implementation.
Keywords Public aspects of medicine ; RA1-1270
Subject code 360
Language English
Publishing date 2022-01-01T00:00:00Z
Publisher Public Library of Science (PLoS)
Document type Article ; Online
Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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