Knowledge, Attitudes, and Practices of Physicians in Tomsk Oblast Tuberculosis Services Regarding Alcohol Use Among Tuberculosis Patients in Tomsk, Russia

  • Trini A. MathewEmail author
  • Alan L. Shields
  • Aizhan Imasheva
  • Sonya S. Shin
  • Sergey P. Mishustin
  • Gennady G. Peremitin
  • Aivar K. Strelis
  • Galina V. Yanova
  • Shelly F. Greenfield
  • Jennifer J. Furin
Original Paper


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 semistructured interviews with 16 TB physicians and 1 addiction specialist. Interviews were audiorecorded, 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 precontemplative and reluctant to seek 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. 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 improves TB outcomes among patients with co-occurring AUDs.


Alcohol Tuberculosis Physicians Russia 



The authors would like to thank all the physicians who participated in this study, Dr. Sergey Yanov for technical advice, the Eli Lilly Foundation for funding and travel support (T.A.M., S.S.S., and J.J.F.) and the National Institute on Drug Abuse for research support (S.F.G.; Grant K24DA019855).


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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Trini A. Mathew
    • 1
    Email author
  • Alan L. Shields
    • 2
  • Aizhan Imasheva
    • 3
  • Sonya S. Shin
    • 4
  • Sergey P. Mishustin
    • 5
  • Gennady G. Peremitin
    • 5
  • Aivar K. Strelis
    • 6
  • Galina V. Yanova
    • 7
  • Shelly F. Greenfield
    • 8
  • Jennifer J. Furin
    • 4
  1. 1.Division of Infectious DiseasesUniversity of Mississippi Medical CenterJacksonUSA
  2. 2.Department of PsychologyEast Tennessee State UniversityJohnson CityUSA
  3. 3.Washington, DCUSA
  4. 4.Division of Global Health EquityBrigham and Women’s HospitalBostonUSA
  5. 5.Tomsk Oblast Tuberculosis ServicesTomskRussian Federation
  6. 6.Tuberculosis and Pulmonology DepartmentSiberian State Medical UniversityTomskRussian Federation
  7. 7.Tomsk Oblast Clinical Tuberculosis HospitalTomskRussian Federation
  8. 8.Harvard Medical School, Alcohol and Drug Abuse Treatment ProgramMcLean HospitalBelmontUSA

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