No action is without its side effects : adverse drug reactions and missed doses of anti-tuberculosis therapy, a scoping review
Abstract
Aim A key reason for the failure of anti-tuberculosis (TB) treatment is missed doses (instances where medication is not taken). Adverse drug reactions (ADRs) are one cause of missed doses, but the global evidence, their relative contribution to missed doses versus other causes, the patterns of missed doses due to ADRs, and the specific ADRs associated with missed doses have not been appraised. We sought to address these questions through a scoping review. Methods MEDLINE, Embase and Web of Science were searched on 3 November 2021 using terms around active TB, missed doses and treatment challenges. Studies reporting both ADR and missed dose data were examined. (PROSPERO: CRD42022295209). Results Searches identified 108 eligible studies. 88/108 (81%) studies associated ADRs with an increase in missed doses. 33/61 (54%) studies documenting the reasons for missed doses gave ADRs as a primary reason. No studies examined patterns of missed doses due to ADRs. 41/108 (38%) studies examined associations between 68 types of ADR (across 15 organ systems) and missed doses. Nuance around ADR-missed doses relations regarding drug susceptibility testing profile and whether the missed doses originated from the patient, healthcare professionals, or both were found. Conclusions There is extensive evidence that ADRs are a key driver for missed doses of anti-TB treatment. Some papers examined specific ADRs and none evaluated the patterns of missed doses due to ADRs, demonstrating a knowledge deficit. Knowing why doses both are and are not missed is essential in providing targeted interventions to improve treatment outcomes.
Citation
Dixon , E G , Rasool , S , Otaalo , B , Motee , A , Dear , J W , Sloan , D & Stagg , H R 2023 , ' No action is without its side effects : adverse drug reactions and missed doses of anti-tuberculosis therapy, a scoping review ' , British Journal of Clinical Pharmacology , vol. 90 , no. 1 . https://doi.org/10.1111/bcp.15908
Publication
British Journal of Clinical Pharmacology
Status
Peer reviewed
ISSN
0306-5251Type
Journal item
Description
This research was funded in whole by the UK Medical Research Council (MRC) [MR/N013166/1]; this grant funds EGD’s PhD. HRS is supported by theMRC [MR/R008345/1] and through the National Institute for Health Research (NIHR) Health Technology Assessment Programme, UK [16/88/06]. JWD is supported by the MRC [MR/V038303/1,MR/T044802/1], Chief Scientist Office [TCS/21/04] and Rosetrees Trust [CF1\100010].Collections
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