No action is without its side effects: adverse drug reactions and missed
doses of anti-tuberculosis therapy, a scoping review
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