Factors Associated with Adherence to the 2022 Pre-Employment Algorithm for Asymptomatic Patients with Suspected Pulmonary Tuberculosis Among Pulmonologists in the Lung Center of The Philippines

Anthea Grace Esver; Precious Mae Gomez; Pamela Joy Dionisio; Eileen Aniceto

doi:10.70172/pjcd.v22i2.10049

Authors

Anthea Grace B. Esver, MD Lung Center of the Philippines, Quezon City
Precious Mae A. Gomez, MD Lung Center of the Philippines, Quezon City
Pamela Joy V. Dionisio, MD Lung Center of the Philippines, Quezon City
Eileen G. Aniceto, MD, MBA Lung Center of the Philippines, Quezon City

DOI:

https://doi.org/10.70172/pjcd.v22i2.10049

Keywords:

pre-employment clearance, tuberculosis, fit to work, FGD, awareness

Abstract

Background
Pulmonary tuberculosis is a global health concern and a leading cause of death from infectious diseases. Screening is crucial in high prevalence TB-areas such as the Philippines, particularly among asymptomatic patients. This study explores factors influencing pulmonologists' adherence to the 2022 Pre-Employment Algorithm at the Health and Fitness Assessment Office (HFAO) of the Lung Center of the Philippines.

Methodology
Using a sequential explanatory mixed-methods design, the study conducted a quantitative survey of 16 HFAO pulmonologists, followed by a qualitative focused group discussion (FGD) with 12 participants. Thematic analysis of FGD transcripts provided insights into factors influencing adherence to the algorithm.

Results
The quantitative phase revealed varying awareness and compliance levels among pulmonologists that directly affected adherence to the algorithm. The FGD identified these specific factors influencing adherence: limited awareness resulting in inconsistent application of the guidelines; personal beliefs and patient-related factors influencing individualized decision-making; institutional challenges (i.e., resource constraints) hindering the implementation process; and perceived algorithm inefficacy, coupled with communication barriers among healthcare professionals, further reducing adherence rates.

Conclusions
Knowledge gaps, resource limitations, and personal decision-making significantly affected adherence to the 2022 Pre-Employment Algorithm. Addressing these issues through targeted training, clearer guidelines, and improved resource management can improve adherence and enhance TB screening outcomes.

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This article has supplementary materials which can be accessed here.

Author Biographies

Anthea Grace B. Esver, MD, Lung Center of the Philippines, Quezon City

Department of Pulmonary, Critical Care and Sleep Medicine

Precious Mae A. Gomez, MD, Lung Center of the Philippines, Quezon City

Department of Pulmonary, Critical Care and Sleep Medicine

Pamela Joy V. Dionisio, MD, Lung Center of the Philippines, Quezon City

Emergency and Outpatient Department

Eileen G. Aniceto, MD, MBA, Lung Center of the Philippines, Quezon City

Hospital Support Services

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