Treatment Adherence and Influencing Factors in Patients with Tuberculosis during the COVID-19 Pandemic: A Mixed Method Study

Aims: This study aimed to determine the adherence to treatment and affecting factors in tuberculosis patients during COVID-19 outbreaks. Instrument Methods: This is a mixed-method study with an explanatory sequential design. The first phase was a cross-sectional study on 108 tuberculosis patients. Data were collected with an adherence questionnaire in patients with chronic disease. Descriptive statistics and linear regression tests were used for quantitative data analysis. The second phase was a qualitative study with the conventional content analysis approach. Participants included 12 patients and healthcare providers involved in the directly observed treatment short course program for tuberculosis in related centers to Iranshahr University of Medical Sciences, Southeast of Iran. Findings: The median scores of treatment adherence were 110.00±35.00, and 48 (44%) of subjects had poor to moderate scores. COVID-19 and non-COVID-19 factors have influenced the adherence to treatment in patients with tuberculosis patients. Conclusion: A worldwide and unanticipated crisis can negatively affect the control of chronic diseases.  Anxiety and panic over the unknown nature, lack of definitive treatment, and mortality of COVID-19 led to the disruption of the directly observed therapies program by both tuberculosis patients and healthcare providers. Giving part of the tuberculosis management responsibility to the patient and family was not an effective solution during the COVID-19 crisis.