Crocker-Buque, Tim;
Hayden, Harry;
White, Jacqui;
Dekoningh, Jennifer;
Belton, Moerida;
Boparai, Narinder;
Brown, James;
... North Central London Tuberculosis Service; + view all
(2024)
Providing personalised care for people with tuberculosis: an evaluation of enhanced case management in a UK TB Network 2013 to 2021.
JRSM Open
, 15
(10)
pp. 1-9.
10.1177/20542704241290486.
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Abstract
Objectives: Evaluating the outcomes of enhanced case management (ECM) for patients with tuberculosis (TB) in the North Central London TB Service (NCLTBS). // Design: Retrospective cohort study. // Setting: The NCLTBS provides care for persons diagnosed with TB across north and central London. Management involves both medical and psychosocial support, leading to the implementation ECM to provide additional non-clinical assistance to patients at risk of treatment non-completion. However, there has been limited evaluation of its outcomes. // Participants: All adults with TB notified to NCLTBS between January 2013 and June 2021. // Main outcome measures: Descriptive socio-economic and clinical characteristics grouped by binary ECM status (yes/no) and level (0–3). Clinical outcomes at 12 months (completed treatment, death, lost-to-follow-up, continuing on treatment) were compared using multivariable logistic regression. // Results: Totally, 2437 patients were included (57.2% male, 79.1% born outside the UK). Overall, 82.3% completed treatment and 4.1% died. Factors associated with mortality included older age (over 70 years odds ratio (OR) 3.3), inpatient diagnosis (OR 4.4), and mental health issues (OR 2.2). 52.8% received ECM, with the proportion increasing over time, and 76% of this group successfully competed treatment. // Conclusions: This comprehensive evaluation of ECM in a diverse London population indicates high treatment completion rates even among those with multiple social risk factors. However, ECM needs of patients has increased over time, with a particular rise in patients requiring the highest support level. Given the small difference between standard care and ECM categories 1 and 2, there may be scope to simplify the system.
| Type: | Article |
|---|---|
| Title: | Providing personalised care for people with tuberculosis: an evaluation of enhanced case management in a UK TB Network 2013 to 2021 |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1177/20542704241290486 |
| Publisher version: | http://dx.doi.org/10.1177/20542704241290486 |
| Language: | English |
| Additional information: | Copyright © 2024 The Author(s). This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
| Keywords: | Tuberculosis, respiratory medicine, infectious diseases, effectiveness of care, evidence-based practice |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10200681 |
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