Towards an understanding of non-compliance. An assessment of risk factors for defaulting from leprosy treatment

Within the Eastern Leprosy Control Project of Nepal, a retrospective case c ontrol study looked for simple factors that might be used operationally to predict non-compliant behaviour in patients. Patients with these factors wo uld then become the targets of measures such as intensified health educatio n messages and home visits in order to reduce the risk of defaulting. A stu dy of 1442 patient cards (half defaulters, half treatment completed) reveal ed occasional small but significant demographic and clinical differences, b ut none was of a sufficient magnitude to be operationally useful. Review of the attendance of patients in the first few months of treatment suggested that eventual defaulting was strongly associated with irregularity from the commencement of treatment. It is possible that an early indicator based on attendance over the first months can be used to target patients who are in danger of non-completion of treatment.