Effects of Ecuador's national monetary incentive program on adherence to treatment for drug-resistant tuberculosis

The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease
A SripadC Freile

Abstract

Non-adherence to tuberculosis (TB) treatment jeopardizes patient health and promotes disease transmission. In July 2011, Ecuador's National Tuberculosis Program (NTP) enacted a monetary incentive program giving adherent drug-resistant TB (DR-TB) patients a US240 bonus each month. To describe patients' experiences with the program qualitatively, and to assess its effects on treatment adherence. We interviewed 92 current and five default patients about their treatment experience. NTP data on DR-TB patients receiving treatment were used to compare 12-month default rates among the incentive program group and non-program controls. Our interviews found that patients are financially challenged and use the bonus for a variety of expenses, most commonly food. The most common complaint was that bonus payments were frequently delayed. The 1-year default rate among program patients (9.5%) was significantly lower than the rate among pre-program patients (26.7%). Ecuador's monetary incentive program alleviates the economic burden placed by treatment on patients. The bonus does not, however, directly address other treatment barriers, including psychological distress and side effects. The program could benefit from timely delivery of payments....Continue Reading

Citations

Feb 18, 2016·Transactions of the Royal Society of Tropical Medicine and Hygiene·Ana W TorrensMauro N Sanchez
Sep 19, 2018·The American Journal of Tropical Medicine and Hygiene·Amrita DaftaryEric Goosby
Feb 3, 2018·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Ming-Chih YuYi-Wen Huang
May 17, 2019·Revista Panamericana De Salud Pública = Pan American Journal of Public Health·Jaqueline Garcia de Almeida BallesteroPedro Fredemir Palha
Jan 2, 2020·Revista Panamericana De Salud Pública = Pan American Journal of Public Health·Nelly Tatés-OrtegaEdith Alarcón-Arrascue

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