Factors Associated with Latent Tuberculosis Treatment Initiation for Primary Care Patients in a Large Health System

Background: One of the mainstays of eliminating tuberculosis as a public health threat is through the treatment of latent tuberculosis infections (LTBI). To determine ways to improve LTBI treatment rates, we assessed factors associated with LTBI treatment initiation in United States (US)-based primary care clinics. Methods: Using electronic health record data, we identified adult primary care patients in a US-based health system who screened positive for LTBI from January 2016 to December 2023. We used univariate and multivariate logistic regression to assess if a variety of factors had associations with LTBI treatment initiation. Results: Of the 851 primary care patients who screened positive for LTBI, 41% were prescribed LTBI treatment. If treatment was started by a general primary care provider, international clinic provider or an infectious diseases provider, majority of patients were prescribed a rifamycin-containing regimen while majority of treatment regimens started by HIV primary care providers were isoniazid-only regimens. Age over 65 showed decreased likelihood of being started on LTBI treatment, while assistance from infectious diseases consultation, primary care provided in HIV primary clinic or international clinic, and being self-pay/financial assistance status showed an increased likelihood of being prescribed LTBI treatment. Conclusion: Our study highlights areas in which formal training and guidance with LTBI management could improve treatment initiation rates.