Prescription patterns and treatment outcomes of MDR ‐ TB patients treated within and outside the N ational T uberculosis P rogramme in P ham N goc T hach hospital, V iet N am

Objective To describe and analyse the prescription patterns and treatment outcomes of MDR ‐ TB patients managed within G reen L ight C ommittee ( GLC ) and outside (non‐ GLC ) the National TB programme in Viet Nam. Methods Retrospective cohort study with two elements: (i) in‐depth interviews and focus group discussions with clinical doctors, hospital pharmacists, and the non‐ GLC patients with MDR ‐ TB ; (ii) review of treatment cards and patients' charts of all GLC and non‐ GLC patients with MDR ‐ TB put on treatment during 2010. Results Of 282 patients with MDR ‐ TB , comprising 79 (28%) GLC patients MDR ‐ TB and 203 (72%) non‐ GLC patients with MDR ‐ TB , were enrolled in the study. Treatment delay was significantly higher in the GLC group (12.8 days) than the non‐ GLC group (2.3 days), ( P  = 0.004). The success rate was significantly better in GLC patients (84.8%) than in non‐ GLC patients (53.7%) ( P  < 0.001). The default rate was significantly higher in non‐ GLC patients than in GLC patients (25.6% vs. 6.3%), ( P  < 0.001). The risk of unsuccessful outcome was higher in non‐ GLC patients (Hazard ratio = 4.6, 95% CI : 1.8–11.8). Conclusions The treatment outcomes of patients with MDR ‐ TB in the GLC group were significantly better than in the non‐ GLC group. Reasons for the high default rate in non‐ GLC patients with MDR ‐ TB must be further investigated.