Exploration of Concordance Behavior between Tuberculosis Patients, Families, and Healthcare Workers in Supporting Treatment Adherence: A Qualitative Study

Background: Indonesia continues to face a significant problem with Tuberculosis (TB), ranking as the country with the second highest global burden. Concordance behavior is crucial to treatment adherence. However, understanding of concordance behavior determinants remains incomplete. Objective: This study aims to explore the understanding and experience of TB patients, their families, and health workers regarding communication in support of TB treatment concordance. Methods: We employed a phenomenological design to explore the lived experiences of individuals involved in TB treatment. Semi-structured interviews were conducted with a purposive sample of TB patients, family members, and healthcare workers at primary healthcare centers in Padang City, Indonesia. We utilized the Braun and Clarke approach-guided thematic analysis to identify salient themes emerging from the interview data. Results: Data analysis yielded four principal themes: understanding of concordance, the role of the family in treatment communication, communication barriers, and effective communication strategies to support the concordance. Many patients and relatives were unsure about TB treatment. Family pressure on medication adherence was significant, yet it sometimes caused patient stress. Healthcare workers' time and TB stigma hindered communication. Brochures, films, and digital media have improved knowledge and adherence. Conclusion: Concordance behavior among patients, families, and healthcare workers is essential. Enhancing adherence necessitates ongoing education, family engagement, and reduction of stigma for TB treatment.