02900nas a2200277   4500000000100000008004100001260001200042653002500054653001200079653001600091653001700107653002200124653002400146100001300170700001400183700001600197700001200213700001400225700001300239245010300252856007000355300000800425490000600433520216900439022001402608       2023                            d  c07/202310ahealthcare providers10aleprosy10aPhilippines10aPrimary care10aQualitative study10aTreatment adherence1 aPepito V1 aLoreche A1 aSamontina R1 aAbdon S1 aFuentes D1 aSaniel O00aFactors affecting treatment adherence among leprosy patients: Perceptions of healthcare providers.  uhttps://www.cell.com/action/showPdf?pii=S2405-8440%2823%2905183-6  a1-80 v93 a<p><strong>Background: </strong>Treatment adherence is a vital aspect in the management of chronic diseases like leprosy; however, most studies on treatment adherence focus on patients. This study aims to examine the perceptions of healthcare providers on factors that can promote or prevent patients from adhering to treatment.</p>

<p><strong>Methods: </strong>We conducted three focus group discussions (FGDs) with healthcare providers who have at least one year experience in managing leprosy in three large leprosy case-holding hospitals in Metro Manila, Philippines. We audio-recorded, transcribed, translated the FGD proceedings, and analyzed the transcripts thematically to identify patient-intrinsic and patient-extrinsic enablers and barriers to treatment adherence of leprosy patients.</p>

<p><strong>Results: </strong>Patient-intrinsic motivators to complete treatment include innate desire to be cured, fear of infecting family and friends, fear of disability, good knowledge about the disease, need for medical clearance to be considered fit to work, and experiencing leprosy reactions. Patient-extrinsic motivators to complete treatment include free treatment, immediate and sufficient counselling, flexibility in treatment, follow-up and motivation of healthcare workers, and presence of Hansen's Club and support groups. Patient-intrinsic barriers to good treatment adherence include distance between residence and hospital, financial and opportunity costs, adverse drug reactions, misconceptions about being cured, disabilities and presence of leprosy reactions, stubbornness and/or laziness, and undergoing clinical depression. Patient-extrinsic barriers to good treatment adherence include poor availability of MDT, transfer to other leprosy treatment facilities without informing current facility, and stigma.</p>

<p><strong>Conclusion: </strong>Healthcare providers perceive that patient-intrinsic and patient-extrinsic factors influence the treatment adherence of leprosy patients through different mechanisms. We highlight the role of healthcare provider attitudes, stigma, and support groups in promoting treatment adherence.</p>
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