The Relationship Between Family Support and Treatment Adherence in Tuberculosis Patients: A Systematic Review.
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Abstract
Tuberculosis (TB) remains a serious global health threat. The success of therapy depends heavily on patient adherence to long-term treatment. In this context, family support plays a crucial role. Families not only provide emotional support but also ensure adherence to routine treatment and provide support to ensure patients complete their treatment. This systematic review was conducted to identify commonly used research instruments to measure the relationship between family support and treatment adherence. A literature search was conducted using ScienceDirect, PubMed, and Scopus data from December 2025 to February 2026, using the keywords "tuberculosis," "family support," and "treatment adherence." The study selection process was conducted using the Rayyan application and based on a standard PRISMA diagram. The search identified eleven studies using a cross-sectional design. Nine of these studies found a positive association between strong family support and patient adherence, while two studies indicated that a lack of family support was a contributing factor to patient non-adherence to treatment. The use of various instruments in this study, such as the MSPSS, MMAS, MARS, WHOQOL-BREF, PHQ-9, and EQ-5D-5L, reflects a high degree of heterogeneity in the measurement approaches used. Therefore, although this argument confirms a relationship between family support and improved adherence to treatment, the strength of the existing evidence remains limited due to variations in study designs and instruments used. To improve conclusions and comparability between future studies, longitudinal or intervention-based studies using more standardized and consistent measurement instruments are needed.
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References
Emery JC, Richards AS, Dale KD, McQuaid CF, White RG, Denholm JT, et al. Self-clearance of Mycobacterium tuberculosis infection: Implications for lifetime risk and population at-risk of tuberculosis disease. Proceedings of the Royal Society B: Biological Sciences 2021;288. https://doi.org/10.1098/rspb.2020.1635. DOI: https://doi.org/10.1098/rspb.2020.1635
Behr MA, Edelstein PH, Ramakrishnan L. Is Mycobacterium tuberculosis infection life long? The BMJ 2019;367:1–7. https://doi.org/10.1136/bmj.l5770. DOI: https://doi.org/10.1136/bmj.l5770
Dodd PJ, Horton KC. A global analysis of patterns of tuberculosis exposure and transmission. MedRxiv 2025;0:2025.10.09.25337649. DOI: https://doi.org/10.1101/2025.10.09.25337649
Liebenberg D, Gordhan BG, Kana BD. Drug resistant tuberculosis: Implications for transmission, diagnosis, and disease management. Front Cell Infect Microbiol 2022;12:1–18. https://doi.org/10.3389/fcimb.2022.943545. DOI: https://doi.org/10.3389/fcimb.2022.943545
Roba AA, Dasa TT, Weldegebreal F, Asfaw A, Mitiku H, Teklemariam Z, et al. Tuberculosis patients are physically challenged and socially isolated: A mixed methods case-control study of Health Related Quality of Life in Eastern Ethiopia. PLoS One 2018;13:1–14. https://doi.org/10.1371/journal.pone.0204697. DOI: https://doi.org/10.1371/journal.pone.0204697
Baniqued MG, Ballecer BAP, Ballesteros BDC, Balmonte JRR, Bancud EMF, Rebueno MCDR, et al. Social support from nurses and non-adherence with directly observed therapy (DOTS) maintenance phase among patients with tuberculosis in Metro Manila, Philippines. Public Health Nurs 2020;37:339–46. https://doi.org/10.1111/phn.12714. DOI: https://doi.org/10.1111/phn.12714
Khan FMA, Kazmi Z, Hasan MM, dos Santos Costa AC, Ahmad S, Essar MY. Resurgence of tuberculosis amid COVID-19 in Peru: Associated risk factors and recommendations. International Journal of Health Planning and Management 2021;36:2441–5. https://doi.org/10.1002/hpm.3291. DOI: https://doi.org/10.1002/hpm.3291
Maulidan M, Dedi D, Khadafi M. Dukungan Keluarga Berhubungan dengan Kepatuhan Minum Obat pada Pasien Tuberkulosis Paru. Jurnal Penelitian Perawat Profesional 2021;3:575–84. https://doi.org/10.37287/jppp.v3i3.549. DOI: https://doi.org/10.37287/jppp.v3i3.549
Alinaitwe B, Shariff NJ, Madhavi Boddupalli B. Treatment adherence and its association with family support among pulmonary tuberculosis patients in Jinja, Eastern Uganda. Sci Rep 2025;15:1–10. https://doi.org/10.1038/s41598-025-96260-8. DOI: https://doi.org/10.1038/s41598-025-96260-8
Chen X, Xu J, Chen Y, Wu R, Ji H, Pan Y, et al. The relationship among social support, experienced stigma, psychological distress, and quality of life among tuberculosis patients in China. Sci Rep 2021;11:1–11. https://doi.org/10.1038/s41598-021-03811-w. DOI: https://doi.org/10.1038/s41598-021-03811-w
Ahuja N, Kuzmik A, Sznajder K, Lengerich E, Fredrick NB, Chen M, et al. Level of family support and associated factors among pulmonary tuberculosis patients. J Clin Tuberc Other Mycobact Dis 2024;20:2353–64.
Dana NR, Chiau ML, Rahman AD. FAMILY SUPPORT , MOTIVATION , AND TREATMENT : INSIGHTS FROM INDONESIA PATIENT ADHERENCE TO TUBERCULOSIS Department of Medicine , Faculty of Medicine , Universitas Negeri Padang , Bukittinggi , Article History Received : Dec . 20 th 2024 Revised Received : J Infect Dis 2025;19:42–8.
Lei X, Ferrier JA, Jiang H. Quality of life and associated factors among people with chronic diseases in Hubei, China: a cross-sectional study. BMC Public Health 2025;25. https://doi.org/10.1186/s12889-025-22622-6. DOI: https://doi.org/10.1186/s12889-025-22622-6
Ledjepen RDLTG, E.D MA, Sagita S. Hubungan Tingkat Depresi Terhadap Kualitas Hidup Penderita Tuberkulosis Pada Orang Dewasa di Kota Kupang. Cendana Medical Journal 2019;16:79–86.
Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan-a web and mobile app for systematic reviews. Syst Rev 2016;5:1–10. https://doi.org/10.1186/s13643-016-0384-4. DOI: https://doi.org/10.1186/s13643-016-0384-4
Ng J, Szydlowski N, Gill M, Fusco N, Ruiz K. MSR72 An Evaluation of the Rayyan Artificial Intelligence Tool for Systematic Literature Review Screening. Value in Health 2024;27:S273. https://doi.org/10.1016/j.jval.2024.03.1505. DOI: https://doi.org/10.1016/j.jval.2024.03.1505
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. Bmj 2021;372. https://doi.org/10.1136/bmj.n71. DOI: https://doi.org/10.1136/bmj.n71
Moola S, Munn Z, Tufanaru C, Aromataris E, Sears K, Sfetcu, R Currie M, Qureshi R, Mattis P, Lisy K MP-F. Checklist for analytical cross sectional studies. Joanna Briggs Institute Reviewer’s Manual 2017:1–7.
Critical JBI, Checklist A-, The P. PRODUCT REVIEW / ÉVALUATION DE PRODUIT 2019:180–3. https://doi.org/10.29173/jchla29801. DOI: https://doi.org/10.29173/jchla29801
Chen X, Du L, Wu R, Xu J, Ji H, Zhang Y, et al. The effects of Family, Society and National Policy Support on Treatment Adherence among Newly Diagnosed Tuberculosis PatienChen, X. et al. (2020) ‘The effects of Family, Society and National Policy Support on Treatment Adherence among Newly Diagnosed Tube. BMC Infect Dis 2020;20:1–11. DOI: https://doi.org/10.1186/s12879-020-05354-3
Alinaitwe B, Shariff NJ, Boddupalli BM. Level of Family Support and Associated Factors Among Pulmonary Tuberculosis Patients in. J Multidiscip Healthc 2025:2057–73. DOI: https://doi.org/10.2147/JMDH.S511615
Gurusinga R, Afrizal A, Bachtiar A, Firdawati F, Machmud R, Burhan E, et al. The relationship between family support and treatment adherence in patients with tuberculosis in Deli Serdang Regency, Indonesia, 2022: A cross-sectional study. Nurs Midwifery Stud 2024;13:132–9. https://doi.org/10.48307/nms.2024.441017.1351.
Kilima SP, Mubyazi GM, Moolla A, Ntinginya NE, Sabi I, Mwanyonga SP, et al. Perceived access to social support during and after TB treatment in Mbeya and Songwe regions, Tanzania: perspectives from TB patients and survivors set against health care providers. Frontiers in Health Services 2024;4:1–15. https://doi.org/10.3389/frhs.2024.1273739. DOI: https://doi.org/10.3389/frhs.2024.1273739
Fuady A, Arifin B, Yunita F, Rauf S, Fitriangga A, Sugiharto A, et al. Stigma, depression, quality of life, and the need for psychosocial support among people with tuberculosis in Indonesia: A multi-site cross-sectional study. PLOS Global Public Health 2024;4:1–20. https://doi.org/10.1371/journal.pgph.0002489.
Zarova C, Chiwaridzo M, Tadyanemhandu C, Machando D, Dambi JM. The impact of social support on the health-related quality of life of adult patients with tuberculosis in Harare, Zimbabwe: A cross-sectional survey. BMC Res Notes 2018;11:1–7. https://doi.org/10.1186/s13104-018-3904-6. DOI: https://doi.org/10.1186/s13104-018-3904-6
Nursasi AY, Huda MH, Rahmasari SW. Impact of Instrumental Support from Family on Medication Adherence among Tuberculosis Patients. Kesmas 2022;17:251–6. https://doi.org/10.21109/kesmas.v17i4.5927. DOI: https://doi.org/10.21109/kesmas.v17i4.5927
Fang XH, Wu Q, Tao SS, Xu ZW, Zou YF, Ma DC, et al. Social Support and Depression Among Pulmonary Tuberculosis Patients in Anhui, China. J Multidiscip Healthc 2022;15:595–603. https://doi.org/10.2147/JMDH.S356160. DOI: https://doi.org/10.2147/JMDH.S356160
Yadav RK, Kaphle HP, Yadav DK, Marahatta SB, Shah NP, Baral S, et al. Health related quality of life and associated factors with medication adherence among tuberculosis patients in selected districts of Gandaki Province of Nepal. J Clin Tuberc Other Mycobact Dis 2021;23:100235. https://doi.org/10.1016/j.jctube.2021.100235. DOI: https://doi.org/10.1016/j.jctube.2021.100235
Polat H, Turan GB, Tan M. Determining the relationship between stigmatization and social support in tuberculosis patients. J Clin Tuberc Other Mycobact Dis 2024;37:100502. https://doi.org/10.1016/j.jctube.2024.100502. DOI: https://doi.org/10.1016/j.jctube.2024.100502
Fuady A, Arifin B, Yunita F, Rauf S, Fitriangga A, Sugiharto A, et al. Stigma, depression, quality of life, and the need for psychosocial support among people with tuberculosis in Indonesia: A multi-site cross-sectional study. PLOS Global Public Health 2024;4:1–20. https://doi.org/10.1371/journal.pgph.0002489. DOI: https://doi.org/10.1371/journal.pgph.0002489
Zefanya Cheline Saragih, Ayu Rifqi Indah G, Nurul Lisa Isnaini. Uji Validitas Konstruk Multidimensional Scale of Perceived Social Support (MSPSS) melalui Confirmatory Factor Analysis (CFA). Jurnal Riset Rumpun Ilmu Sosial, Politik Dan Humaniora 2026;5:734–47. https://doi.org/10.55606/jurrish.v5i1.7811. DOI: https://doi.org/10.55606/jurrish.v5i1.7811
Kusumaningrum RAR, Sipollo BV, Sakti IP. Self-efficacy dengan Kepatuhan Minum Obat pada Lansia Penderita Hipertensi di Puskesmas Dau, Kabupaten Malang. Jurnal Keperawatan Profesional (KEPO) 2025;6:184–91. DOI: https://doi.org/10.36590/kepo.v6i1.1452
Abadi K, Kusumawardhani AAAA, Widiasih N, Malik K. Validity and Reliability Test of Medication Adherence Rating Scale for Psychosis (Mars) Instrument Indonesian Version. Jurnal Riset Rumpun Ilmu Sosial, Politik Dan Humaniora Volume 5, Nomor 1, Januari 2026 2018;4:79–87. https://doi.org/10.17501/24246735.2018.4109. DOI: https://doi.org/10.17501/24246735.2018.4109
Purba FD, Hunfeld JAM, Iskandarsyah A, Fitriana TS, Sadarjoen SS, Passchier J, et al. Quality of life of the Indonesian general population: Test-retest reliability and population norms of the EQ-5D-5L and WHOQOL-BREF. PLoS One 2018;13:1–20. https://doi.org/10.1371/journal.pone.0197098. DOI: https://doi.org/10.1371/journal.pone.0197098
Kurniawan D, Fitriawan AS, Setyaningsih WAW, Wulandari AN, Wijoyo EB, Samutri E, et al. Association Between Sources of Social Support and Depression Among Nursing Students During the COVID-19 Pandemic. Nurse Media Journal of Nursing 2024;14:160–74. https://doi.org/10.14710/nmjn.v14i2.56407. DOI: https://doi.org/10.14710/nmjn.v14i2.56407
Linden A Van Der. Cross-cultural validation of the PHQ-9 in Bahasa Indonesia to measure depression among persons affected by leprosy. Medicine 2019:58.