Re-inventing adherence: Toward a patient-centered model of care for drug-resistant tuberculosis and HIV

M. R. O'Donnell, A. Daftary, M. Frick, Y. Hirsch-Moverman, K. R. Amico, M. Senthilingam, A. Wolf, J. Z. Metcalfe, P. Isaakidis, J. L. Davis, J. R. Zelnick, J. C.M. Brust, N. Naidu, M. Garretson, D. R. Bangsberg, N. Padayatchi, G. Friedland

Research output: Contribution to journalArticlepeer-review

56 Scopus citations


BACKGROUND: Despite renewed focus on molecular tuberculosis (TB) diagnostics and new antimycobacterial agents, treatment outcomes for patients co-infected with drug-resistant TB and human immunodeficiency virus (HIV) remain dismal, in part due to lack of focus on medication adherence as part of a patient-centered continuum of care. OBJECTIVE : To review current barriers to drug-resistant TB-HIV treatment and propose an alternative model to conventional approaches to treatment support. DISCUS S ION: Current national TB control programs rely heavily on directly observed therapy (DOT) as the centerpiece of treatment delivery and adherence support. Medication adherence and care for drug-resistant TBHIV could be improved by fully implementing teambased patient-centered care, empowering patients through counseling and support, maintaining a rightsbased approach while acknowledging the responsibility of health care systems in providing comprehensive care, and prioritizing critical research gaps. CONCLUS ION: It is time to re-invent our understanding of adherence in drug-resistant TB and HIV by focusing attention on the complex clinical, behavioral, social, and structural needs of affected patients and communities.

Original languageEnglish (US)
Pages (from-to)430-434
Number of pages5
JournalInternational Journal of Tuberculosis and Lung Disease
Issue number4
StatePublished - Apr 1 2016


  • Drug-resistant TB
  • HIV
  • Medication adherence
  • Patient-centered care

ASJC Scopus subject areas

  • General Medicine


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