{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:26:24Z","timestamp":1791296784424,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2012,11,30]],"date-time":"2012-11-30T00:00:00Z","timestamp":1354233600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2013,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess patient adherence to unsupervised single\u2010drug miltefosine treatment for visceral leishmaniasis and to identify the factors influencing adherence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a prospective cohort study of 171 patients with <jats:styled-content style=\"fixed-case\">V<\/jats:styled-content>isceral leishmaniasis (<jats:styled-content style=\"fixed-case\">VL<\/jats:styled-content>) in three healthcare settings in <jats:styled-content style=\"fixed-case\">N<\/jats:styled-content>epal. Adherence was assessed through pill count, checking of treatment cards and adherence questionnaires, as well as miltefosine concentration measurements at the end of treatment. Poor adherence was defined as less than 90% of required capsules taken.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patient adherence to miltefosine was 83%. Predictors of adherence were being the male sex (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a02.60, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.02\u20136.67) and knowing the duration of treatment (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a03.05, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.16\u20138.04). Adherence was also better for patients who were literate and knew the side effects of treatment. Gastrointestinal side effects and negligence after the resolution of clinical symptoms of <jats:styled-content style=\"fixed-case\">VL<\/jats:styled-content> were the main reasons for poor adherence. Poor adherence was associated (though not statistically significant) with future relapse.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Effective counselling during the treatment, a short take\u2010home message on <jats:styled-content style=\"fixed-case\">VL<\/jats:styled-content> and on side effects and action of miltefosine, and follow\u2010up visits are the best way to prevent poor adherence. Single end\u2010of\u2010treatment measurements of miltefosine concentrations as objective assessment of adherence would only be useful in addition to the subjective assessments when substantial doses of miltefosine have been missed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.12025","type":"journal-article","created":{"date-parts":[[2012,11,30]],"date-time":"2012-11-30T13:16:15Z","timestamp":1354281375000},"page":"179-187","source":"Crossref","is-referenced-by-count":22,"title":["Adherence to miltefosine treatment for visceral leishmaniasis under routine conditions in <scp>N<\/scp>epal"],"prefix":"10.1111","volume":"18","author":[{"given":"Surendra","family":"Uranw","sequence":"first","affiliation":[{"name":"Department of Internal Medicine B.P. 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