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Table 2 Perceived barriers and enablers to the long-term adoption of the LTBI primary care model

From: Improving screening and management of latent tuberculosis infection: development and evaluation of latent tuberculosis infection primary care model

 

Barriers

Enablers

Patient-level

Low motivation to engage with the treatment

Difficulty in processing diagnosis-related information

Competing priorities

Patient education sessions delivered by trained RHN both prior to, and as required throughout, treatment

Provider-level

Low confidence in identifying and responding to adverse reactions caused by LTBI medication

Participation in high quality primary care provider education sessions

Ongoing support from MHRHW infectious diseases physicians

Co-design and established relationships with infectious diseases physicians

Familiarity with cultural and clinical aspects relevant to the refugee patient group

Multilingual proficiency and interpreter access

Organisational-level

Operational limitations including:

Limited time for patient education and follow-up

Lack of workforce to coordinate patient education and follow-up

Limited financial resources

Extensive involvement of MHRHW RHN in patient follow-up

Extended GP consultations

Designated resources and time to support patient education and clinical follow-up

Resources to proactively contact patients who fail to attend appointments or pick up medication

Clinical-level

Available treatment barriers:

Adverse reactions

Length of treatment

Free access to medication