The Relationship between Concordance Behaviour with Treatment Compliance and Quality Of Life of Patients with Pulmonary Tuberculosis in Medan

BACKGROUND: Indonesia is the country with the second highest number of tuberculosis in the world. Patient compliance with tuberculosis treatment is still very low. Thus the success rate of treatment is also unsatisfactory. Concordance behaviour is a model of the doctor-patient relationship that combines aspects of the partnership, sharing decision making and trust. It is considered better than adherence to improve compliance and quality of life in patients with pulmonary tuberculosis. AIM: This study aims to assess the relationship between concordance and the level of adherence to pulmonary tuberculosis treatment along with the quality of life in Medan. METHODS: A cross-sectional study was conducted on 259 tuberculosis patients from several clinics and hospitals in Medan from 2015 to 2017, by asking patients to fill out questionnaires that had been tested for validity and reliability first. The concordance behaviour questionnaire contains 56 questions covering aspects of knowledge, partnership, sharing decision making, trust, and support. While compliance was measured by 14 questions covering attitude and behaviour. Statistical analysis was performed by Chi-Square test in SPSS v20. RESULTS: This study shows that most TB patients (75.7%) have a good concordance, in which the aspect of knowledge, partnership, sharing and support were all good. However, the component of trust in the most patient (75.7%) was still low. Based on the level of compliance, 84.2% of patients had good compliance. However, the level of behaviour in 55.2% of patients was still low. Statistical analysis showed that there was a significant relationship between concordance and compliance (p = 0.009), in which patient with good concordance had 2.6 higher probability for good compliance. However, there was no significant association between concordance and quality of life (p = 0.63). CONCLUSION: Concordance behaviour is a good concept to be applied to improve treatment compliance of pulmonary TB patients.