Knowledge attitudes and practices of physicians in Tomsk Oblast Tuberculosis Services Regarding Alcohol Use Among Tuberculosis Patients in Tomsk Russia

摘要

In recent years, the Russian Federation has seen a dramatic rise in morbidity and mortality from tuberculosis (TB), attributed in part to an increase in alcohol use disorders (AUDs), which are associated with worse TB treatment outcomes. This study describes the knowledge, attitudes and practices of physicians who treat TB patients in Tomsk, Russia. We conducted semi-structured interviews with 16 TB physicians and one addiction specialist. Interviews were audio-recorded, transcribed, translated, and systematically analyzed. We identified four key domains: definitions of alcohol use and abuse, and physicians' knowledge, attitudes, and practices regarding these problems. Physicians described patients as largely pre-contemplative and reluctant in seeking treatment. Physicians recognized their limited knowledge in diagnosing and treating AUDs but expressed interest in acquiring these skills. Few options are currently available for treatment of AUDs in TB patients in Tomsk, Russia. These findings suggest that Tomsk physicians are aware of the need to engage AUDs in TB patients but identify a knowledge gap that restricts their ability to do so. Training TB physicians to use simple screening instruments and deliver evidence-based alcohol interventions improve TB outcomes among patients with co-occurring AUDs.