Factors influencing treatment decisions for latent Tuberculosis infection: A qualitative study among patients attending health clinics in Selangor, Malaysia

Clinical Research Results Abstract IntroductionTreatment of Latent Tuberculosis Infection (LTBI) can reduce Tuberculosis mortality.(1) Various guideline advocate treatment of LTBI (2); however, there are many factors that influenced treatment decisions among patients. A key aspect to improve treatment uptake is to understand factors that influence treatment decision. Hence, this study aimed to explore the facilitators and barriers that may influence patients’ decision to receive or refuse treatment for LTBI. MethodsPatients diagnosed with LTBI were recruited from primary health clinics in Petaling District, Selangor Malaysia based on purposive sampling based on age, gender, occupation, and treatment decisions. Face to face in-depth interviews were conducted prior to the COVID-19 pandemic and phone interview with audio recording during the pandemic. A semi structured topic guide was developed based on the Common-Sense Model of Self-Regulation and literature review. Audio recordings were transcribed verbatim and analyzed thematically. Results26 interviews were conducted, six themes emerged: Treatment decision was influenced by participants’ poor knowledge and misconception. Participants also surrendered their treatment decision to health care practitioner (HCP), who at times lacked competency and clinical skills. Treatment decision was also made based on perceived susceptibility to LTBI, participants’ perception of LTBI stigma and stigma from the community. ConclusionPatients with LTBI had poor awareness and knowledge regarding LTBI resulting in a reliance on HCP to make treatment decision for them. Primary HCP need to equip themselves with knowledge and consultation skills to assist their patients in their decision-making process. A better understanding of patients’ perspective and dissemination of information on LTBI could enhance treatment acceptance. Research Idea Abstract Service Development & Evaluation Abstract Declaration of Interest All authors declares no conflict of interest.This project is registered under the National Medical Research Registry (NMRR-19-3114-50974). This project received funding from the Ministry of Health, National Institutes of Health Research Grant (MRG). Ethical approval for this study was obtained from the Medical Research & Ethics Committee (MREC): KKM/ NIHSEC/P19-2683(11). References and Clinical Trial Registry Information 1. World Health Organization. Global tuberculosis report 2018. Geneva,2018.2. Latent Tuberculosis Infection: Updated and consolidated guidelines for programmatic management. Geneva: World Health Organization, 2018.