Skip to main content

Advertisement

SpringerLink
Log in

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

  • Original Paper
  • Published:
Culture, Medicine, and Psychiatry Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price includes VAT (Finland)

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Babor, T. F., et al. 2001 The Alcohol Use Disorders Identification Test (AUDIT): Guidelines for Use in Primary Care. Geneva: World Health Organization, Department of Mental Health and Substance Abuse.

    Google Scholar 

  • Bobak, M., et al. 1999 Alcohol Consumption in a National Sample of the Russian Population. Addiction 94(6):857–866.

    Article  Google Scholar 

  • Dewan, P. K., et al. 2004 Risk Factors for Death during Tuberculosis Treatment in Orel, Russia. International Journal of Tuberculosis & Lung Disease 8(5):598–602.

    Google Scholar 

  • Dossing, M., et al. 1996 Liver Injury during Antituberculosis Treatment: An 11-Year Study. Tubercle & Lung Disease 77(4):335–340.

    Article  Google Scholar 

  • Farmer, P., and J. Y. Kim 1998 Community Based Approaches to the Control of Multidrug Resistant Tuberculosis: Introducing “DOTS-Plus.” British Medical Journal 317(7159):671–674.

    Google Scholar 

  • Fernandez-Villar, A., et al. 2004 The Influence of Risk Factors on the Severity of Anti-Tuberculosis Drug-Induced Hepatotoxicity. International Journal of Tuberculosis & Lung Disease 8(12):1499–1505.

    Google Scholar 

  • Fleming, P. M. 1996 Drug and Alcohol User Treatment/Intervention Services in Russia—A Western Perspective. Substance Use and Misuse 31(1):103–114.

    Article  Google Scholar 

  • Glyn, T. J., and M. W. Manley 1989 How to Help Your Patients Stop Smoking: A Manual for Physicians. NIH publication no. 89-3064. Bethesda, MD: National Cancer Institute.

    Google Scholar 

  • Khomenko, A.G., et al. 1989 Alkogolizm i Tuberkulez Legkikh. Vestnik Akademii Meditsinskikh Nauk SSSR (2): 50–58.

  • Kimerling, M. E. 2000 The Russian Equation: An Evolving Paradigm in Tuberculosis Control. International Journal of Tuberculosis & Lung Disease 4(12):S160–S167.

    Google Scholar 

  • Krupitsky, E. M., et al. 2006 Co-Morbidity of Infectious and Addictive Diseases in St. Petersburg and the Leningrad Region, Russia. European Addictions Research 12(1):12–19.

    Article  Google Scholar 

  • Mathew, T.A., et al. 2006 Causes of Death during Tuberculosis Treatment in Tomsk Oblast, Russia. International Journal of Tuberculosis & Lung Disease 10(8):857–863.

    Google Scholar 

  • Mathew, T.A., et al. 2009a Integration of Alcohol Use Disorders Identification and Management in the Tuberculosis Programme in Tomsk Oblast, Russia. European Journal of Public Health 19(1):16–18.

    Article  Google Scholar 

  • Mathew, T.A., et al. 2009b Performance of the Alcohol Use Disorders Identification Test among Tuberculosis Patients in Russia. Substance Use and Misuse (in press).

  • Mawer, C., et al. 2001 Comparison of the Effectiveness of WHO Short-Course Chemotherapy and Standard Russian Antituberculous Regimens in Tomsk, Western Siberia. Lancet 358(9280):445–449.

    Article  Google Scholar 

  • Miller, W. R., and S. Rollnick 2002 Motivational Interviewing: Preparing People for Change. Book Review. Journal of Studies on Alcohol 63(6):776–777.

    Google Scholar 

  • Nelson, S., et al. 1995 Alcohol, Tumor Necrosis Factor, and Tuberculosis. Alcoholism: Clinical and Experimental Research 19(1):17–24.

    Article  Google Scholar 

  • Nemtsov, A. 2005 Russia: Alcohol Yesterday and Today. Addiction 100(2):146–149.

    Article  Google Scholar 

  • NIAAA 2003 Helping Patients with Alcohol Problems: A Health Practitioner’s Guide. Bethesda, MD: Institute of Alcohol Abuse and Alcoholism (NIAAA).

    Google Scholar 

  • Nilssen, O., et al. 2005 Alcohol Consumption and Its Relation to Risk Factors for Cardiovascular Disease in the North-west of Russia: The Arkhangelsk Study. International Journal of Epidemiology 34(4):781–788.

    Article  Google Scholar 

  • Pablos-Mendez, A., et al. 1997 Nonadherence in Tuberculosis Treatment: Predictors and Consequences in New York City. American Journal of Medicine 102(2):164–170.

    Article  Google Scholar 

  • Plavinski, S. L., S. I. Plavinskaya, and A. N. Klimov 2003 Social Factors and Increase in Mortality in Russia in the 1990 s: Prospective Cohort Study. British Medical Journal 326(7401):1240–1242.

    Article  Google Scholar 

  • Prochaska, J. O., C. C. DiClemente, and J. C. Norcross 1992 In Search of How People Change Applications to Addictive Behaviors. American Psychologist 47(9):1102–1114.

    Article  Google Scholar 

  • Razvodovskii Iu.E. 2004 [Alcohol Sales and Mortality Due to Pulmonary Tuberculosis: Relationships at a Populational Level]. Problemy Tuberkuleza i Bolezneĭ Legkikh (9): 53–55.

  • Ryan, M. 1995 Alcoholism and rising Mortality in the Russian Federation. British Medical Journal 310(6980):646–648.

    Google Scholar 

  • Saitz, R., et al. 2002 Professional Satisfaction Experienced When Caring for Substance-Abusing Patients: Faculty and Resident Physician Perspectives. Journal of General Internal Medicine 17(5):373–376.

    Google Scholar 

  • Schoeman, J. H., et al. 1994 Assessment of Alcohol-Screening Instruments in Tuberculosis Patients. Tuberculosis & Lung Disease 75(5):371–376.

    Article  Google Scholar 

  • Shin, S. S., et al. 2006 Treatment Outcomes in an Integrated Civilian and Prison MDR-TB Treatment Program in Russia. International Journal of Tuberculosis & Lung Disease 10(4):402–408.

    Google Scholar 

  • Walberg, P., et al. 1998 Economic Change, Crime, and Mortality Crisis in Russia: Regional Analysis. British Medical Journal 317(7154):312–318.

    Google Scholar 

  • World Health Organization 2003 Treatment of Tuberculosis. Vol. 2005. Geneva, Switzerland: World Health Organization.

  • Yanova, G. V. 1994 Alkogolizm sredi bolnikh tuberkulezom legkih v Zapadnoi Sibiri i puti organizatsii ih meditsinskoi reabilitatsii. Avtoref. Sibirskiy Gossudarstvenniy Meditsinskiy Universitet.

    Google Scholar 

  • Zhamborov, KhKh. 1999 [Analysis of Mortality Rates among Patients with Pulmonary Tuberculosis]. Problemy Tuberkuleza (4): 12–13.

  • Zuger, A. 2000 Infectious Diseases Rising Again in Russia. In The New York Times (excerpts). New York.

Download references

Acknowledgments

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).

Author information

Authors and Affiliations

  1. Division of Infectious Diseases, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA

    Trini A. Mathew

  2. Department of Psychology, East Tennessee State University, Box 70649, Johnson City, TN, 37614, USA

    Alan L. Shields

  3. 1230 13th Street, Apt 918, NW, Washington, DC, 20005, USA

    Aizhan Imasheva

  4. Division of Global Health Equity, Brigham and Women’s Hospital, 651 Huntington Avenue, Boston, MA, 02115, USA

    Sonya S. Shin & Jennifer J. Furin

  5. Tomsk Oblast Tuberculosis Services, R. Luxembourg 17, Tomsk, Tomsk Oblast, 634009, Russian Federation

    Sergey P. Mishustin & Gennady G. Peremitin

  6. Tuberculosis and Pulmonology Department, Siberian State Medical University, Moskovky trakt 2, Tomsk, Tomsk Oblast, 634050, Russian Federation

    Aivar K. Strelis

  7. Tomsk Oblast Clinical Tuberculosis Hospital, Ul. Novaya 1, Timiryazevo, Tomsk, Tomsk Oblast, 634510, Russian Federation

    Galina V. Yanova

  8. Harvard Medical School, Alcohol and Drug Abuse Treatment Program, McLean Hospital, 115 Mill Street, Belmont, MA, 02478, USA

    Shelly F. Greenfield

Authors
  1. Trini A. Mathew
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alan L. Shields
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Aizhan Imasheva
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sonya S. Shin
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sergey P. Mishustin
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Gennady G. Peremitin
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Aivar K. Strelis
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Galina V. Yanova
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Shelly F. Greenfield
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Jennifer J. Furin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Trini A. Mathew.

Additional information

This work was carried out while Dr. Mathew was an ID fellow at Beth Israel Deaconess Medical Center and research fellow at Division of Social Medicine and Health Inequalities, Brigham and Women’s Hospital, Boston.

Dr. Peremitin is now retired from Tomsk Oblast Tuberculosis Services.

Aivar K. Strelis—Deceased, 2009.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mathew, T.A., Shields, A.L., Imasheva, A. et al. Knowledge, Attitudes, and Practices of Physicians in Tomsk Oblast Tuberculosis Services Regarding Alcohol Use Among Tuberculosis Patients in Tomsk, Russia. Cult Med Psychiatry 33, 523–537 (2009). https://doi.org/10.1007/s11013-009-9148-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11013-009-9148-0

Keywords

Search

Navigation