Health Literacy as A Determinant of Treatment Success in Multidrug Resistance Tuberculosis: A Systematic Review

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Health literacy, defined as the ability to access, understand, evaluate, and apply health information, may play a role as a modifiable determinant of MDR-TB treatment success. Methods Two databases (PubMed and Scopus) were used following the PRISMA guidelines to find articles published between January 1st, 2015, and October 11st, 2025. A total of 231 records were identified and seven articles were included in this systematic review. Results Health literacy was operationalized via patient knowledge, counseling/education, self-care behaviors, communication, and digital adherence support, with outcomes capturing adherence, completion, attitudes, self-care, and literacy levels. Synthesis suggested a consistent directionality in which literacy-oriented strategies and communication-focused approaches aligned with improved adherence and programmatic indicators, while contextual and methodological heterogeneity limited cross-study comparability. Conclusion Available evidence supports health literacy as a promising, modifiable lever to enhance MDR-TB adherence and treatment success, particularly when addressed through multi-component, patient-centered strategies. Future work should use validated, multidomain literacy instruments and robust designs to quantify effects and guide scalable, literacy-sensitive MDR-TB programs. " } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://f1000research.com/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://f1000research.com/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://f1000research.com/articles/15-576", "name": "Health Literacy as A Determinant of Treatment Success in Multidrug..." } } ] } Home Browse Health Literacy as A Determinant of Treatment Success in Multidrug... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Sugiarsi S, Sulaeman ES, Anantanyu S and Lestari A. Health Literacy as A Determinant of Treatment Success in Multidrug Resistance Tuberculosis: A Systematic Review [version 1; peer review: awaiting peer review] . F1000Research 2026, 15 :576 ( https://doi.org/10.12688/f1000research.178915.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Systematic Review Health Literacy as A Determinant of Treatment Success in Multidrug Resistance Tuberculosis: A Systematic Review [version 1; peer review: awaiting peer review] Sri Sugiarsi https://orcid.org/0000-0001-5148-9326 1 , Endang Sutisna Sulaeman 1 , Sapja Anantanyu 1 , Anik Lestari 1 Sri Sugiarsi https://orcid.org/0000-0001-5148-9326 1 , Endang Sutisna Sulaeman 1 , Sapja Anantanyu 1 , Anik Lestari 1 PUBLISHED 19 Apr 2026 Author details Author details 1 Doctoral Program of Development Extension and Community Empowerment, Universitas Sebelas Maret, Surakarta, Central Java, 57126, Indonesia Sri Sugiarsi Roles: Conceptualization, Investigation, Methodology, Writing – Original Draft Preparation Endang Sutisna Sulaeman Roles: Project Administration, Supervision, Validation, Writing – Review & Editing Sapja Anantanyu Roles: Project Administration, Supervision, Validation, Writing – Review & Editing Anik Lestari Roles: Methodology, Supervision, Validation, Writing – Review & Editing OPEN PEER REVIEW REVIEWER STATUS AWAITING PEER REVIEW Abstract Background Multidrug-resistant tuberculosis (MDR-TB) remains a serious global health threat, with treatment success rates stagnating despite advances in therapy. Health literacy, defined as the ability to access, understand, evaluate, and apply health information, may play a role as a modifiable determinant of MDR-TB treatment success. Methods Two databases (PubMed and Scopus) were used following the PRISMA guidelines to find articles published between January 1st, 2015, and October 11st, 2025. A total of 231 records were identified and seven articles were included in this systematic review. Results Health literacy was operationalized via patient knowledge, counseling/education, self-care behaviors, communication, and digital adherence support, with outcomes capturing adherence, completion, attitudes, self-care, and literacy levels. Synthesis suggested a consistent directionality in which literacy-oriented strategies and communication-focused approaches aligned with improved adherence and programmatic indicators, while contextual and methodological heterogeneity limited cross-study comparability. Conclusion Available evidence supports health literacy as a promising, modifiable lever to enhance MDR-TB adherence and treatment success, particularly when addressed through multi-component, patient-centered strategies. Future work should use validated, multidomain literacy instruments and robust designs to quantify effects and guide scalable, literacy-sensitive MDR-TB programs. READ ALL READ LESS Keywords Health Literacy, Multidrug-resistant, Systematic Review, Treatment, Tuberculosis Corresponding Author(s) Sri Sugiarsi ( [email protected] ) Close Corresponding author: Sri Sugiarsi Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2026 Sugiarsi S et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Sugiarsi S, Sulaeman ES, Anantanyu S and Lestari A. Health Literacy as A Determinant of Treatment Success in Multidrug Resistance Tuberculosis: A Systematic Review [version 1; peer review: awaiting peer review] . F1000Research 2026, 15 :576 ( https://doi.org/10.12688/f1000research.178915.1 ) First published: 19 Apr 2026, 15 :576 ( https://doi.org/10.12688/f1000research.178915.1 ) Latest published: 19 Apr 2026, 15 :576 ( https://doi.org/10.12688/f1000research.178915.1 ) Introduction Tuberculosis (TB) remains one of the leading causes of death from infectious disease globally, despite major advances in diagnosis and treatment. 1 According to the World Health Organization (WHO) Global Tuberculosis Report 2024, 1 an estimated 10.3 million people developed TB in 2023, with 1.3 million deaths among HIV-negative individuals and 167,000 deaths among those living with HIV. Among all forms of TB, multidrug-resistant and rifampicin-resistant tuberculosis (MDR/RR-TB) represents one of the most critical public health threats. 2 In 2023, approximately 410,000 people developed MDR/RR-TB, but treatment success remained at only around 50%, far below the End TB Strategy target of 90%. 3 The low success rate reflects the persistent challenges of long treatment duration, severe drug-related side effects, and high loss-to-follow-up rates, especially in low- and middle-income countries (LMICs) where TB burden is highest. 4 Treatment adherence is the cornerstone of successful MDR-TB management. 5 Patients are required to complete months of multidrug regimens with strict dosing schedules and frequent clinical monitoring. 6 Non-adherence contributes to treatment failure, relapse, and the emergence of multidrug-resistant TB (XDR-TB), which further complicates control efforts. 7 While structural and programmatic barriers such as drug stock-outs, limited healthcare access, and inadequate supervision are well documented, behavioral and cognitive determinants of adherence are increasingly recognized as critical but underexplored. 8 Patients’ understanding of their disease, their ability to follow medical instructions, and their confidence in communicating with healthcare providers are essential components of long-term treatment success. These elements are collectively influenced by health literacy. 9 Health literacy, as defined by the WHO and Nutbeam’s conceptual model, is the ability of individuals to access, understand, evaluate, and apply health-related information to make informed decisions regarding their health. 1 It encompasses three progressive domains, functional, communicative, and critical literacywhich collectively determine how effectively individuals can engage with the healthcare system. 10 Evidence from chronic diseases such as diabetes, hypertension, and HIV demonstrates that higher health literacy is associated with better treatment adherence, improved self-management, and reduced hospitalization rates. 11 Conversely, low health literacy has been linked to poor medication compliance, misunderstanding of instructions, delayed care-seeking, and increased morbidity. 12 In the context of TB, patients with limited literacy may struggle to comprehend complex treatment regimens, recognize side effects, or maintain consistent communication with health professionals, thereby increasing the risk of poor outcomes. 13 Previous studies on TB adherence have primarily focused on pharmacological, structural, or technological interventions rather than literacy-related factors. 14 For instance, research on directly observed therapy (DOTS) emphasized supervision and logistical support, while more recent digital adherence technologies such as electronic medication monitors and mobile phone reminders have improved monitoring capacity but do not always address the underlying issue of comprehension and empowerment. 15 Moreover, patient education and counseling interventions have shown promise in enhancing adherence, yet these initiatives often lack a standardized framework for assessing or improving health literacy levels. 16 Systematic reviews on TB adherence have largely evaluated intervention effectiveness or digital innovations, but few have specifically examined health literacy as a determinant of treatment success in MDR-TB. Consequently, there remains a critical gap in understanding how literacy shapes adherence behaviors, patient–provider communication, and long-term outcomes within MDR-TB programs. This study aimed to summary the evidence on health literacy as a determinant of treatment success in MDR-TB and describe intervention approaches targeting literacy-related domains. Methods* Study design This systematic review was conducted to synthesize existing evidence on the relationship between health literacy and treatment success in patients with multidrug-resistant tuberculosis (MDR-TB) between January 1, 2015, and October 11, 2025. This review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines. All identified records were imported into Zotero ( https://www.zotero.org/accessed on 11 October 2025) for reference management and automatic duplicate removal. Search strategy A comprehensive literature search was performed in PubMed and Scopus databases on October 11, 2025. The search strategy combined Medical Subject Headings (MeSH) and free-text terms related to tuberculosis, health literacy, and treatment outcomes. The search key included a combination of keywords: “multidrug-resistant tuberculosis” OR “MDR-TB” OR “rifampicin-resistant tuberculosis” AND “health literacy” OR “health education” OR “health information” OR “self-care behavior” AND “treatment outcome” OR “treatment success” OR “adherence” OR “completion.”. Additional articles were identified by manually screening the reference lists of relevant studies and grey literature in WHO and World Bank repositories, as well as Google Scholar. Eligibility criteria Studies were considered eligible if they investigated health literacy, patient knowledge, or educational interventions as determinants, mediators, or predictors of treatment adherence or treatment success among patients diagnosed with multidrug-resistant or rifampicin-resistant tuberculosis (MDR/RR-TB). Eligible studies included those employing quantitative, qualitative, or mixed-methods designs, published as peer-reviewed full-text articles in English between January 2015 and October 2025. Studies were excluded if they focused exclusively on drug-susceptible tuberculosis, lacked original outcome data (such as review articles, commentaries, editorials, or study protocols), or were conference abstracts without peer review. Study selection Two independent reviewers screened the titles and abstracts of all retrieved records using predefined eligibility criteria in Rayyan AI software. 17 Discrepancies were resolved through discussion and consensus. Full texts of potentially relevant articles were then reviewed to confirm eligibility. A third reviewer verified the inclusion list to ensure completeness. For each included study, the following data were extracted into a standardized Excel template: author, year, country, study design, study type, evaluation method, and outcomes ( Table 1 ). Data synthesis was performed through descriptive summary and thematic analysis of relationships between health literacy dimensions and MDR-TB treatment outcomes. This systematic review was not prospectively registered in the PROSPERO database. Table 1. Main characteristics of the studies. Author (year) Country Design Study type Duration of intervention Evaluation Outcome Charalambous et al. (2024) 18 South Africa Cluster RCT Digital adherence system (Wisepill EvriMED + tiered feedback) vs standard care 45 months Adherence (≥80%), clinical outcomes Adherence improved (81% vs 51%), but no significant difference in treatment outcomes. Dilas et al. (2023) 19 Peru Cross-sectional Nurse-led health education mediating social support–adherence link 10 months SEM mediation model Health education significantly improved adherence and mediated social support effects. Peresu et al. (2022) 20 Eswatini Cross-sectional KAP of community supporters delivering MDR-TB injections 1 months Questionnaire & observation KAP satisfactory, but 35% held stigma; highlights need for literacy-oriented MDR-TB training. Thomas et al. (2021) 21 India Qualitative Medication Event Reminder Monitor (digital pillbox for MDR-TB) 11 months Thematic analysis (UTAUT framework) Highly acceptable; improved organization and HCP relations; barriers: stigma, device issues. Horter et al. (2020) 22 Uzbekistan Qualitative Person-centred MDR-TB care (short-course regimen) 2 months In-depth interviews with patients & HCWs Dialogue and education built trust and motivation; improved adherence through engagement. Deshmukh et al. (2018) 23 India Qualitative (Grounded Theory) Social, family, and counselling support (PSG model) 7 months Thematic analysis (Social Cognitive Theory) Key adherence drivers: awareness, counselling, family/social support, nutrition. Leeka et al. (2025) 24 Thailand Case–control Determinants of MDR-TB (health literacy, attitudes, self-care, income) 6 months Multivariable logistic regression Low HL (AOR = 2.11) independently predicted MDR-TB; poor attitude/self-care also significant. Results* The systematic search yielded a total of 231 records, consisting of 42 from PubMed and 189 from Scopus. Following the removal of 68 duplicates, 163 unique records were screened for eligibility based on titles and abstracts. During this phase, 152 records were excluded for not meeting the predefined inclusion criteria due to factors such as inappropriate study design (n = 48), publication type (n = 39), study population (n = 24), or reported outcomes (n = 41). The remaining 11 full-text articles were retrieved for comprehensive evaluation. After detailed assessment, four articles were excluded two that did not contain a specific health-literacy-related intervention and two that were not available in open access format. Ultimately, seven studies satisfied all inclusion criteria and were incorporated into the final synthesis, as illustrated in ( Figure 1 ). Figure 1. PRISMA flowchart diagram. Figure 1 illustrates the identification, screening, eligibility assessment, and inclusion of studies following the PRISMA guidelines. Summary of included studies A total of seven studies published between 2018 and 2025 met the inclusion criteria and were incorporated into the final synthesis ( Table 1 ). These studies were conducted across six low- and middle-income countries: India (n = 2), Uzbekistan (n = 1), Thailand (n = 1), Eswatini (n = 1), Peru (n = 1), and South Africa (n = 1) (see Table 1 ). Collectively, they represent diverse regional contexts of multidrug-resistant tuberculosis (MDR-TB) management and various methodological approaches, including one cluster randomized controlled trial, one case–control study, two cross-sectional analytical studies, and three qualitative investigations. The interventions examined were heterogeneous in design and focus, reflecting multiple operationalizations of health literacy. Quantitative studies primarily assessed patient education, health literacy levels, self-care behaviours, and determinants of adherence using standardized questionnaires and statistical modelling. Qualitative research explored communication, counselling, and patient provider relationships through thematic and grounded theory approaches. Duration of interventions ranged from one month to forty-five months, indicating variability in the depth and sustainability of implementation across settings. In South Africa, 18 a cluster randomized trial evaluated a digital adherence support system using Wisepill EvriMED with tiered feedback, demonstrating improved adherence rates compared to standard care. Cross-sectional studies in Peru 19 and Eswatini 20 investigated nurse-led health education and the knowledge, attitudes, and practices of community treatment supporters, respectively. In India 21 and Uzbekistan, 22 qualitative studies assessed patient experiences with digital pillboxes and person-centered care models, emphasizing engagement and communication in MDR-TB management. A grounded theory study 23 further highlighted the role of family and social support in adherence. Finally, a case–control study in Thailand 24 identified limited health literacy as an independent predictor of MDR-TB occurrence, underscoring literacy’s influence on patient outcomes. Overall, the included studies captured a broad spectrum of literacy-related interventions, ranging from digital tools and educational counselling to person-centered frameworks, evaluated through both behavioural and clinical indicators of adherence and treatment success. Discussion* To the best of our knowledge, this is the first systematic review to critically synthesize the evidence on the role of health literacy in determining treatment success for multidrug-resistant tuberculosis (MDR-TB). Our analysis of seven geographically diverse studies confirms that health literacy is a pivotal, yet complex, factor in MDR-TB care. However, it also reveals a field in its infancy, characterized by conceptual fragmentation and methodological challenges that must be addressed to translate potential into practice. Conceptual fragmentation and the operationalization of health literacy A primary finding of this review is the striking conceptual inconsistency in how health literacy is operationalized across the MDR-TB literature. We observed a conceptual blurring where “health literacy” was interchangeably used to describe patient knowledge, educational interventions, self-care behaviors, and communication skills. This conflation treats health literacy as both an input and an outcome, thereby complicating the synthesis of evidence and obscuring the true mechanistic role it plays. For instance, Study in Eswatini 20 measured literacy via knowledge and attitudes, 20 study in Peru 19 framed it as an educational intervention mediating social support. To advance this field, it is imperative to adopt a unified theoretical framework, such as Sørensen’s Integrated Model, which distinguishes between functional (accessing and understanding information), interactive (communicating and applying information), and critical (critically appraising information for informed decision-making) health literacy dimensions. 25 The critical gap highlighted by our review is the complete absence of studies using validated, multidomain health literacy instruments tailored to the MDR-TB context. Without such tools, we cannot pinpoint which specific literacy dimension understanding drug side-effects (functional) or negotiating treatment with a provider (interactive) is most predictive of treatment success, thereby hindering the development of targeted interventions. Mechanistic pathways linking health literacy to treatment success Beyond mere association, our synthesis elucidates the complex, multi-faceted mechanistic pathways through which health literacy influences MDR-TB outcomes. The evidence demonstrates that its role is not monolithic but context-dependent. It functions as a direct predictor, as shown study in Thailand 24 where low health literacy independently doubled the odds of MDR-TB. More subtly, it acts as a mediator, exemplified study in Peru, 19 where health literacy was the crucial cognitive and skills-based mechanism that translated external social support into internalized motivation and actionable self-care behaviors, ultimately improving adherence. Furthermore, health literacy serves as a critical enabler for digital health technologies. The studies in India 21 and South Africa 18 demonstrate that the efficacy of digital pillboxes and adherence monitors is contingent upon a patient’s baseline literacy to interpret device alerts, understand their significance, and problem-solve technical issues. This novel insight moves the field beyond a simple linear correlation and positions health literacy as a dynamic competency that interacts with and amplifies other therapeutic factors. The efficacy and active components of literacy-sensitive interventions The included studies evaluated a spectrum of intervention modalities, from digital pillboxes to person-centred counselling. Our analysis suggests that while technology-driven tools show promise for objective monitoring, the most profound impacts on long-term adherence likely stem from interactive, dialogue-based models. The Study in Uzbekistan 22 on person-centred care is paradigmatic; its effectiveness lies in its direct cultivation of interactive health literacy. By fostering open dialogue between patients and healthcare workers, 26 it builds trust, mutual understanding, and shared decision-making, which in turn enhances intrinsic motivation and the problem-solving skills necessary to navigate a lengthy 27 and arduous treatment course. 28 , 29 A critical synthesis of these findings leads us to highlight that the most successful interventions are inherently multi-component. They do not seek to improve literacy in a vacuum but integrate literacy support within a broader framework that simultaneously addresses structural barriers such as stigma, 23 nutritional support, and socioeconomic constraints, creating a holistic ecosystem for patient success. Contextual drivers and the imperative for localized strategies The exclusive derivation of evidence from low- and middle-income countries (LMICs) 18 , 23 underscores the global health equity dimensions of the MDR-TB challenge and rightly focuses attention on the settings where the burden is greatest. Our review clearly indicates that local context acts as a powerful effect modifier. The impact of a health literacy intervention is not determined solely by its design but is profoundly shaped by local health system structures, cultural beliefs about illness and medication, and the pervasive level of TB-related stigma, which varied significantly between the settings in Eswatini, 20 Peru, 19 and India. 21 This necessitates a fundamental rejection of the “one-size-fits-all” approach. 30 Strategies must be locally adapted and co-designed with communities to ensure cultural resonance 31 and address context-specific barriers. 24 In this endeavour, the dual role of community health workers and peer supporters, as highlighted across multiple studies, 32 becomes indispensable. They act not only as literacy facilitators but also as cultural translators, effectively bridging the chasm between the formal health system and the patient’s lived experience. 33 This review consolidates compelling evidence that strengthening health literacy is a viable and patient-centric strategy to improve MDR-TB treatment outcomes. It is a modifiable determinant that operates through direct, mediated, and enabling pathways and is most effectively bolstered through multi-component, person-centred interventions. However, these conclusions must be interpreted in the context of this review’s limitations. The small number of included studies (n = 7), their significant methodological heterogeneity (encompassing RCTs, cross-sectional, and qualitative designs), and the restriction to English-language publications may introduce selection bias and limit the generalizability of our findings. Furthermore, the conceptual fragmentation discussed earlier inherently constrains the robustness of any cross-study synthesis. These limitations, however, clearly chart the course for future research. There is an urgent need for prospective cohort studies that employ validated, multidimensional health literacy instruments to establish causal relationships and quantify the effect size of specific literacy dimensions. Concurrently, the field requires the development and rigorous evaluation of complex interventions specifically designed to target functional, interactive, and critical health literacy within MDR-TB care programs. Translating this evidence into practice demands that national TB programs move beyond passive information dissemination and instead integrate routine health literacy assessments and train healthcare providers in literacy-sensitive communication techniques. By doing so, we can leverage health literacy not just as a concept, but as a powerful, evidence-based tool to combat the global threat of MDR-TB. Conclusion This systematic review establishes health literacy as a critical and modifiable determinant of treatment success in multidrug-resistant tuberculosis (MDR-TB), functioning through direct, mediated, and enabling pathways. The findings advocate for the integration of structured, multidimensional health literacy assessments into MDR-TB programs and highlight the superior efficacy of interactive, person-centred interventions over passive education. These insights position enhanced health literacy as a viable, patient-centric strategy to improve adherence and outcomes in MDR-TB care. However, the current evidence base is limited by conceptual inconsistencies and methodological heterogeneity. Therefore, future research must employ validated health literacy instruments to precisely quantify its impact and develop targeted interventions, which is essential for optimizing MDR-TB treatment and curbing the global threat of drug resistance. Data availability* All data underlying the results are available as part of the article and no additional source data are required. Extended data supporting this study are available in Figshare. 34 Figshare: PRISMA flowchart for “Health Literacy as a Determinant of Treatment Success in Multidrug-Resistant Tuberculosis: A Systematic Review” https://doi.org/10.6084/m9.figshare.31821010 34 Data are available under the terms of the Creative Commons Zero "No rights reserved" data waiver (CC0 1.0 Public domain dedication) . Acknowledgements The authors would like to express their gratitude to the Graduate School of Universitas Sebelas Maret for providing institutional support and access to resources during the preparation of this systematic review. References* 1. WHO, W. H. O: Global tuberculosis report 2024.2024. Reference Source 2. Dheda K, et al. : Multidrug-resistant tuberculosis. Nat. Rev. Dis. Primers. 2024; 10 : 22. 3. Patel MN, Patel AJ, Nandpal MN, et al. : Advancing against drug-resistant tuberculosis: an extensive review, novel strategies and patent landscape. Naunyn Schmiedeberg's Arch. Pharmacol. 2025; 398 : 2127–2150. Publisher Full Text 4. Abubakar A: Evaluation of determinants, acceptability and effectiveness of community-based management of multidrug-resistant tuberculosis (MDR-TB) in Nigeria. Anglia Ruskin Research Online (ARRO); 2024. 5. Soumya P, et al. : A Descriptive Study on Treatment Adherence and Associated Factors in Patients Receiving Anti-TB Drugs. J Pharm Sci Comput Chem. 2025; 1 : 58–68. 6. Vrijens B, Urquhart J: Patient adherence to prescribed antimicrobial drug dosing regimens. J. Antimicrob. Chemother. 2005; 55 : 616–627. Publisher Full Text 7. Santosa A, Juniarti N, Pahria T, et al. : Integrating narrative and bibliometric approaches to examine factors and impacts of tuberculosis treatment non-compliance. Multidiscip. Respir. Med. 2025; 20 : 1016. Publisher Full Text 8. Holtzman CW, Brady KA, Yehia BR: Retention in care and medication adherence: current challenges to antiretroviral therapy success. Drugs. 2015; 75 : 445–454. Publisher Full Text 9. Edwards M, Wood F, Davies M, et al. : The development of health literacy in patients with a long-term health condition: the health literacy pathway model. BMC Public Health. 2012; 12 : 130. PubMed Abstract | Publisher Full Text | Free Full Text 10. Chinn D: Critical health literacy: A review and critical analysis. Soc. Sci. Med. 2011; 73 : 60–67. Publisher Full Text 11. Mackey LM, Doody C, Werner EL, et al. : Self-management skills in chronic disease management: what role does health literacy have?. Med. Decis. Mak. 2016; 36 : 741–759. Publisher Full Text 12. Xu Y, An L, Zhang Y, et al. : Structural Equation Model of Medical Seeking Delay in Elderly Breast Cancer Patients: The Mediating Role of Coping Mechanisms Between Health Literacy and Timeliness of Treatment. ANZ J. Surg. 2025; 95 : 2123–2130. Publisher Full Text 13. Munro SA, Lewin SA, Smith HJ, et al. : Patient adherence to tuberculosis treatment: a systematic review of qualitative research. PLoS Med. 2007; 4 : e238. PubMed Abstract | Publisher Full Text | Free Full Text 14. Moodley N, Saimen A, Zakhura N, et al. : ‘They are inconveniencing us’-exploring how gaps in patient education and patient centred approaches interfere with TB treatment adherence: perspectives from patients and clinicians in the Free State Province, South Africa. BMC Public Health. 2020; 20 : 454. Publisher Full Text 15. Car J, Tan WS, Huang Z, et al. : eHealth in the future of medications management: personalisation, monitoring and adherence. BMC Med. 2017; 15 : 73. PubMed Abstract | Publisher Full Text | Free Full Text 16. Sudore RL, Schillinger D: Interventions to improve care for patients with limited health literacy. J. Clin. Outcomes Manag. JCOM. 2009; 16 : 20. 17. Ouzzani M, Hammady H, Fedorowicz Z, et al. : Rayyan—a web and mobile app for systematic reviews. Syst. Rev. 2016; 5 : 1–10. Publisher Full Text 18. Charalambous S, Maraba N, Jennings L, et al. : Treatment adherence and clinical outcomes amongst in people with drug-susceptible tuberculosis using medication monitor and differentiated care approach compared with standard of care in South Africa: a cluster randomized trial. eClinMed. 2024; 75 . Publisher Full Text 19. Dilas D, Flores R, Morales-García WC, et al. : Social Support, Quality of Care, and Patient Adherence to Tuberculosis Treatment in Peru: The Mediating Role of Nurse Health Education. Patient Prefer. Adherence. 2023; 17 : 175–186. PubMed Abstract | Publisher Full Text | Free Full Text 20. Peresu E, Heunis JC, Kigozi NG, et al. : Knowledge, attitudes and practices of community treatment supporters administering multidrug-resistant tuberculosis injections: A cross-sectional study in rural Eswatini. PLOS ONE. 2022; 17 : e0271362. PubMed Abstract | Publisher Full Text | Free Full Text 21. Thomas BE, Kumar JV, Periyasamy M, et al. : Acceptability of the medication event reminder monitor for promoting adherence to multidrug-resistant tuberculosis therapy in two indian cities: Qualitative study of patients and health care providers. J. Med. Internet Res. 2021; 23 : e23294. PubMed Abstract | Publisher Full Text | Free Full Text 22. Horter S, Stringer B, Gray N, et al. : Person-centred care in practice: Perspectives from a short course regimen for multi-drug resistant tuberculosis in Karakalpakstan, Uzbekistan. BMC Infect. Dis. 2020; 20 : 675. Publisher Full Text 23. Deshmukh RD, Dhande DJ, Sachdeva KS, et al. : Social support a key factor for adherence to multidrug-resistant tuberculosis treatment. Indian J. Tuberc. 2018; 65 : 41–47. PubMed Abstract | Publisher Full Text 24. Leeka N, Laohasiriwong W, Mahato RK, et al. : Factors influencing the risk of developing multidrug-resistant pulmonary tuberculosis in Northeast Thailand. J Clin Tuberc Other Mycobact Dis. 2025; 40 : 100549. Publisher Full Text 25. Sørensen K, van den Broucke S, Fullam J, et al. : Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health. 2012; 12 : 80. Publisher Full Text 26. Razzaque R, Stockmann T: An introduction to peer-supported open dialogue in mental healthcare. BJPsych Adv. 2016; 22 : 348–356. Publisher Full Text 27. Denet L, Napala A, Kurmen G: Analysis of intrinsic motivation during a Problem-Solving activity.2022. 28. Marino L, Capone V: Psychosocial factors contributing to value creation in value-based healthcare: a scoping review. Front. Psychol. 2024; 15 : 1323110. PubMed Abstract | Publisher Full Text | Free Full Text 29. von Knorring J , Lehti A, Lindvall K, et al. : I Want to be Known as a Whole Human Being: A Qualitative Study About Patients’ Experiences of Empathy in Health Care. J. Patient Exp. 2025; 12 : 23743735251369702. PubMed Abstract | Publisher Full Text | Free Full Text 30. Carroll MW: One size does not fit all: A framework for tailoring intellectual property rights. Ohio St LJ. 2009; 70 : 1361. 31. Maye L, Claisse C: Co-design within and between communities in cultural heritage: current and open questions. Multimodal Technol Interact. 2022; 7 (1). Publisher Full Text 32. Kok MC, Ormel H, Broerse JEW, et al. : Optimising the benefits of community health workers’ unique position between communities and the health sector: a comparative analysis of factors shaping relationships in four countries. Glob. Public Health. 2017; 12 : 1404–1432. PubMed Abstract | Publisher Full Text 33. Singleton K, Krause E: Understanding cultural and linguistic barriers to health literacy. Online J. Issues Nurs. 2009; 14 . Publisher Full Text 34. Sugiarsi S: PRISMA Dataset and Checklist about TB.2026. Publisher Full Text Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 19 Apr 2026 ADD YOUR COMMENT Comment Author details Author details 1 Doctoral Program of Development Extension and Community Empowerment, Universitas Sebelas Maret, Surakarta, Central Java, 57126, Indonesia Sri Sugiarsi Roles: Conceptualization, Investigation, Methodology, Writing – Original Draft Preparation Endang Sutisna Sulaeman Roles: Project Administration, Supervision, Validation, Writing – Review & Editing Sapja Anantanyu Roles: Project Administration, Supervision, Validation, Writing – Review & Editing Anik Lestari Roles: Methodology, Supervision, Validation, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (1) version 1 Published: 19 Apr 2026, 15:576 https://doi.org/10.12688/f1000research.178915.1 Copyright © 2026 Sugiarsi S et al . 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