Adherence to Treatment

In order to cure TB and prevent drug resistance, patients with TB disease must adhere to treatment.

Non-adherence to treatment can lead to treatment failure and the development of

drug-resistant TB.

Adherence to treatment may be difficult for many reasons. For example:

Treatment for TB disease lasts many months
Patients may start to feel better soon after taking their medication and no longer have symptoms, thus making them reluctant to continue taking several medications

Directly Observed Therapy

The most effective strategy to ensure adherence to treatment is directly observed therapy (DOT).

With DOT, a patient meets with a health care worker every day or several times a week. The patient takes the TB medicines while the health care worker watches. The health care worker also asks the patient about any problems or side effects with the medication. DOT should be done at a time and place that is convenient for the patient.

DOT should be used for ALL patients with TB disease, including children and adolescents. There is no way to accurately predict whether a patient will adhere to treatment without this assistance.

Incentives and Enablers

Another way to help ensure adherence to TB disease treatment is through the use of incentives and enablers.

Incentives are small rewards given to the patient. Incentives may include gift cards or food vouchers.
Enablers are anything that helps the patient more readily complete therapy or show up for their DOT appointment. Enablers may include bus tokens or cab fare.

Patient Education

An important part of helping patients take their medicine is to educate them about TB. Thus, all TB patients should be educated about TB disease and treatment.

This includes information regarding

Cause of TB
TB transmission
Diagnosis of TB
Treatment plan
How to take medication
Side effects to medication
Measures to prevent the spread of TB (infection control)