City Research Online

Abstract

Objectives: There is scant qualitative research into the experiences of tuberculosis treatment in urban risk groups with complex health and social needs in the UK. This study aimed to describe the social context of adherence to treatment in marginalised groups attending a major tuberculosis centre in London.

Methods: Qualitative cross-sectional study using semi-structured interviews with patients receiving treatment for tuberculosis. Analytical frameworks aimed to reflect the role of broader social structures in shaping individual health actions.

Results: Seventeen participants, the majority were homeless and had complex medical and social needs including, drug and alcohol use or immigration problems affecting entitlement to social welfare. Participants rarely actively chose not to take their medication but described a number of social and institutional barriers to adherence and their need for practical support. Many struggled with the physical aspects of taking medication and the side effects. Participants receiving DOT reported both positive and negative experiences reflecting type of DOT provider and culture of the organisation.

Conclusions: There is a need for integrated care across drug, alcohol, HIV and homeless services in order to address complex clinical co-morbidities and social need which impact on patients’ ability to sustain a course of treatment.

Publication Type:	Article
Additional Information:	© 2015, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/
Publisher Keywords:	Tuberculosis, social determinants, adherence, homeless persons, drug users, stigma
Subjects:	H Social Sciences > HM Sociology R Medicine > RC Internal medicine
Departments:	School of Health & Psychological Sciences
SWORD Depositor:	Symplectic Administrator

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