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Outcomes of a residential respite service for homeless people with tuberculosis in London, UK: a cross-sectional study

BACKGROUND: Many countries are seeking to eliminate tuberculosis (TB), but incidence remains high in socially excluded groups such as people experiencing homelessness. There is limited research into the effectiveness of residential respite services (RRS), which provide accomodation and social and cl...

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Autores principales: Crosby, L, Lewer, D, Appleby, Y, Anderson, C, Hayward, A, Story, A
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10068400/
https://www.ncbi.nlm.nih.gov/pubmed/35506684
http://dx.doi.org/10.1177/17579139221093544
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author Crosby, L
Lewer, D
Appleby, Y
Anderson, C
Hayward, A
Story, A
author_facet Crosby, L
Lewer, D
Appleby, Y
Anderson, C
Hayward, A
Story, A
author_sort Crosby, L
collection PubMed
description BACKGROUND: Many countries are seeking to eliminate tuberculosis (TB), but incidence remains high in socially excluded groups such as people experiencing homelessness. There is limited research into the effectiveness of residential respite services (RRS), which provide accomodation and social and clinical support for homeless people with active TB. METHODS: We used a register of all cases of TB diagnosed in London between 1 January 2010 and 3 October 2019 to compare characteristics and outcomes of patients treated in an RRS with patients receiving standard care. The primary outcome was successful treatment completion. We used logistic regression to compare likelihood of completing treatment, and simulation to estimate the absolute change in treatment completion resulting from this service. RESULTS: A total of 78 homeless patients finished an episode of TB treatment at the RRS. Patients treated in the RRS were more likely than patients treated in standard care to have clinical and social risk factors including drug resistance, history of homelessness, drug or alcohol use, and need for directly observed therapy. After adjusting for these factors, patients treated in the RRS had 2.97 times the odds of completing treatment (95% CI = 1.44–6.96). Treatment ended in failure for 8/78 patients treated in the RRS (10%, 95% CI = 5%–20%). We estimated that in the absence of the RRS, treatment would have ended in failure for 17/78 patients (95% CI = 11–25). CONCLUSION: The residential respite service for homeless TB patients with complex social needs was associated with better treatment outcomes.
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spelling pubmed-100684002023-04-04 Outcomes of a residential respite service for homeless people with tuberculosis in London, UK: a cross-sectional study Crosby, L Lewer, D Appleby, Y Anderson, C Hayward, A Story, A Perspect Public Health Peer Review BACKGROUND: Many countries are seeking to eliminate tuberculosis (TB), but incidence remains high in socially excluded groups such as people experiencing homelessness. There is limited research into the effectiveness of residential respite services (RRS), which provide accomodation and social and clinical support for homeless people with active TB. METHODS: We used a register of all cases of TB diagnosed in London between 1 January 2010 and 3 October 2019 to compare characteristics and outcomes of patients treated in an RRS with patients receiving standard care. The primary outcome was successful treatment completion. We used logistic regression to compare likelihood of completing treatment, and simulation to estimate the absolute change in treatment completion resulting from this service. RESULTS: A total of 78 homeless patients finished an episode of TB treatment at the RRS. Patients treated in the RRS were more likely than patients treated in standard care to have clinical and social risk factors including drug resistance, history of homelessness, drug or alcohol use, and need for directly observed therapy. After adjusting for these factors, patients treated in the RRS had 2.97 times the odds of completing treatment (95% CI = 1.44–6.96). Treatment ended in failure for 8/78 patients treated in the RRS (10%, 95% CI = 5%–20%). We estimated that in the absence of the RRS, treatment would have ended in failure for 17/78 patients (95% CI = 11–25). CONCLUSION: The residential respite service for homeless TB patients with complex social needs was associated with better treatment outcomes. SAGE Publications 2022-05-04 2023-03 /pmc/articles/PMC10068400/ /pubmed/35506684 http://dx.doi.org/10.1177/17579139221093544 Text en © Royal Society for Public Health 2022 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Peer Review
Crosby, L
Lewer, D
Appleby, Y
Anderson, C
Hayward, A
Story, A
Outcomes of a residential respite service for homeless people with tuberculosis in London, UK: a cross-sectional study
title Outcomes of a residential respite service for homeless people with tuberculosis in London, UK: a cross-sectional study
title_full Outcomes of a residential respite service for homeless people with tuberculosis in London, UK: a cross-sectional study
title_fullStr Outcomes of a residential respite service for homeless people with tuberculosis in London, UK: a cross-sectional study
title_full_unstemmed Outcomes of a residential respite service for homeless people with tuberculosis in London, UK: a cross-sectional study
title_short Outcomes of a residential respite service for homeless people with tuberculosis in London, UK: a cross-sectional study
title_sort outcomes of a residential respite service for homeless people with tuberculosis in london, uk: a cross-sectional study
topic Peer Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10068400/
https://www.ncbi.nlm.nih.gov/pubmed/35506684
http://dx.doi.org/10.1177/17579139221093544
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