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No action is without its side effects: adverse drug reactions and missed doses of anti-tuberculosis therapy, a scoping review
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  • Eleanor Dixon,
  • Shaista Rasool ,
  • Brian Otaalo,
  • Ashmika Motee,
  • James Dear,
  • Derek Sloan,
  • Helen Stagg
Eleanor Dixon
The University of Edinburgh Usher Institute of Population Health Sciences and Informatics

Corresponding Author:[email protected]

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Shaista Rasool
The University of Edinburgh Usher Institute of Population Health Sciences and Informatics
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Brian Otaalo
Makerere University Infectious Diseases Institute
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Ashmika Motee
The University of Edinburgh Usher Institute of Population Health Sciences and Informatics
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James Dear
Edinburgh University
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Derek Sloan
University of St Andrews
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Helen Stagg
The University of Edinburgh Usher Institute of Population Health Sciences and Informatics
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Abstract

Introduction: A key reason for the failure of anti-tuberculosis (TB) treatment is missed doses (instances where medication is not taken). Adverse drug reactions (ADRs) are one cause of missed doses, but the global evidence for this, their relative contribution to missed doses versus other causes, the patterns of missed doses due to ADRs, and the specific ADRs associated with missed doses have not been appraised. We sought to address these questions through a scoping review. Methods: MEDLINE, Embase and Web of Science were searched on 3 November 2021 using terms around active TB, missed doses and treatment challenges. Studies reporting both ADR and missed dose data were examined. (PROSPERO: CRD42022295209). Results: Searches identified 108 eligible studies. 88/108 (81%) studies associated ADRs with an increase in missed doses. 33/61 (54%) studies documenting the reasons for missed doses gave ADRs as a primary reason. No studies examined patterns of missed doses due to ADRs. 41/108 (38%) studies examined associations between 68 types of ADR (across 15 organ systems) and missed doses. Nuance around ADR-missed doses relations regarding drug susceptibility testing profile and missed dose originator was found. Conclusions: There is extensive evidence that ADRs are a key driver for missed doses of anti-TB treatment. Some papers examined specific ADRs, none evaluated the patterns of missed doses due to ADRs, demonstrating a knowledge deficit. Knowing why doses both are and are not missed due to ADRs is essential in providing targeted interventions to improve treatment outcomes.
04 May 2023Submitted to British Journal of Clinical Pharmacology
05 May 2023Submission Checks Completed
05 May 2023Assigned to Editor
05 May 2023Review(s) Completed, Editorial Evaluation Pending
06 May 2023Reviewer(s) Assigned
22 Jun 2023Editorial Decision: Revise Minor
30 Aug 20231st Revision Received
30 Aug 2023Submission Checks Completed
30 Aug 2023Assigned to Editor
30 Aug 2023Review(s) Completed, Editorial Evaluation Pending
01 Sep 2023Editorial Decision: Revise Minor
01 Sep 20232nd Revision Received
03 Sep 2023Submission Checks Completed
03 Sep 2023Assigned to Editor
03 Sep 2023Review(s) Completed, Editorial Evaluation Pending
04 Sep 2023Editorial Decision: Accept