AIM: To explore the efficacy of hospitals using case management with Directly Observed Treatment - Short course (DOTS) to monitor the adherence of patients with pulmonary tuberculosis in Taiwan. BACKGROUND: Non-adherence to anti-tuberculosis chemotherapy is the major problem in treating patients with tuberculosis. Community-based case management coupled with DOTS has been applied to patients with tuberculosis and has resulted in good results in some countries. Taiwan has a high incidence of tuberculosis, and although it has implemented DOTS, the expected increased efficacy has not yet been realized. DESIGN AND METHODS: The study used a quasi-experimental design. Using age and gender as matching factors, 96 subjects were randomly assigned to one of three groups in 2002-2003. Experimental group I was to receive DOTS case management comprising in-hospital education, direct daily observation in the first two months and one home visit per week. Experimental group II received traditional case management comprising in-hospital education and one home visit per month. The control group did not receive any intervention. RESULTS: The adherence, the rate of completion, the treatment success, sputum conversion and chest X-ray improvement of experimental group I were significantly improved compared with experimental group II and the control group. The completion rate in experimental group I was higher than the general rate for Taiwan during the past six years and the treatment success rate met the standards of the World Health Organization. CONCLUSION: Hospitals using case management with DOTS can improve the adherence of tuberculosis patients and the control of tuberculosis-epidemic situations. Relevance to clinical practice. In a rapidly changing healthcare environment, clinical nurses can make a significant contribution to healthcare delivery for tuberculosis patients. This study has provided further insight into the implementation of hospital-to-community level case management using DOTS by nurses.
RCT Entities:
AIM: To explore the efficacy of hospitals using case management with Directly Observed Treatment - Short course (DOTS) to monitor the adherence of patients with pulmonary tuberculosis in Taiwan. BACKGROUND: Non-adherence to anti-tuberculosis chemotherapy is the major problem in treating patients with tuberculosis. Community-based case management coupled with DOTS has been applied to patients with tuberculosis and has resulted in good results in some countries. Taiwan has a high incidence of tuberculosis, and although it has implemented DOTS, the expected increased efficacy has not yet been realized. DESIGN AND METHODS: The study used a quasi-experimental design. Using age and gender as matching factors, 96 subjects were randomly assigned to one of three groups in 2002-2003. Experimental group I was to receive DOTS case management comprising in-hospital education, direct daily observation in the first two months and one home visit per week. Experimental group II received traditional case management comprising in-hospital education and one home visit per month. The control group did not receive any intervention. RESULTS: The adherence, the rate of completion, the treatment success, sputum conversion and chest X-ray improvement of experimental group I were significantly improved compared with experimental group II and the control group. The completion rate in experimental group I was higher than the general rate for Taiwan during the past six years and the treatment success rate met the standards of the World Health Organization. CONCLUSION: Hospitals using case management with DOTS can improve the adherence of tuberculosispatients and the control of tuberculosis-epidemic situations. Relevance to clinical practice. In a rapidly changing healthcare environment, clinical nurses can make a significant contribution to healthcare delivery for tuberculosispatients. This study has provided further insight into the implementation of hospital-to-community level case management using DOTS by nurses.
Authors: Qin Liu; Katharine Abba; Marissa M Alejandria; David Sinclair; Vincent M Balanag; Mary Ann D Lansang Journal: Cochrane Database Syst Rev Date: 2014-11-18
Authors: April C Pettit; Cathy A Jenkins; Meridith Blevins Peratikos; Marcel Yotebieng; Lameck Diero; Cuong D Do; Jeremy Ross; Valdilea G Veloso; Denise Hawerlander; Olivier Marcy; Bryan E Shepherd; Lukas Fenner; Timothy R Sterling Journal: J Int AIDS Soc Date: 2019-12 Impact factor: 5.396
Authors: Sandra Albino; Karen M Tabb; David Requena; Miguel Egoavil; Maria F Pineros-Leano; Joseph R Zunt; Patricia J García Journal: PLoS One Date: 2014-05-14 Impact factor: 3.240