OBJECTIVE: To evaluate the use of family members as supervisors of directly observed therapy (DOT) in patients with tuberculosis. METHODS: This was a prospective descriptive study involving patients diagnosed with pulmonary tuberculosis. The sample comprised 98 patients. A standardized protocol was implemented in order to train the patient and their families. After the training, the patient was allowed to choose either a family member or a health care worker as a supervisor. Absolute and relative frequencies were used in descriptive data analysis. RESULTS: A family member supervisor was chosen by 94 patients (96%). The cure rate was 99%. The partner was chosen by 49% of the patients, and other family members were chosen by 28%. The heath care team needed to take over DOT in 3% of the cases. Regular attendance at follow-up appointments was 67%. It was observed that 24% of the problems in this DOT model referred to the family supervisor forgetting to administer the medication or to the patient forgetting to take it; 39% of the patients forgot to take the medication for one day, and 31% forgot to take it for two days. There was change of supervisor in 9% of the sample, medication was lost by the patient sometime during treatment in 9%, and patient drug intolerance occurred in 8%. CONCLUSIONS: DOT supervised by a family member has proven an effective and low-cost technique. However, compliance is not due to one single factor but to the combination of strategies adopted: bus passes; educational measures and especially the individualized approach.
OBJECTIVE: To evaluate the use of family members as supervisors of directly observed therapy (DOT) in patients with tuberculosis. METHODS: This was a prospective descriptive study involving patients diagnosed with pulmonary tuberculosis. The sample comprised 98 patients. A standardized protocol was implemented in order to train the patient and their families. After the training, the patient was allowed to choose either a family member or a health care worker as a supervisor. Absolute and relative frequencies were used in descriptive data analysis. RESULTS: A family member supervisor was chosen by 94 patients (96%). The cure rate was 99%. The partner was chosen by 49% of the patients, and other family members were chosen by 28%. The heath care team needed to take over DOT in 3% of the cases. Regular attendance at follow-up appointments was 67%. It was observed that 24% of the problems in this DOT model referred to the family supervisor forgetting to administer the medication or to the patient forgetting to take it; 39% of the patients forgot to take the medication for one day, and 31% forgot to take it for two days. There was change of supervisor in 9% of the sample, medication was lost by the patient sometime during treatment in 9%, and patient drug intolerance occurred in 8%. CONCLUSIONS: DOT supervised by a family member has proven an effective and low-cost technique. However, compliance is not due to one single factor but to the combination of strategies adopted: bus passes; educational measures and especially the individualized approach.
Authors: Madelon Novato Ribeiro; Maria Inês Fernandes Pimentel; Armando de Oliveira Schubach; Raquel de Vasconcellos Carvalhães de Oliveira; José Liporage Teixeira; Madson Pedro da Silva Leite; Monique Fonseca; Ginelza Peres Lima dos Santos; Mariza Matos Salgueiro; Erica de Camargo Ferreira e Vasconcellos; Marcelo Rosandiski Lyra; Mauricio Naoto Saheki; Claudia Maria Valete-Rosalino Journal: Rev Inst Med Trop Sao Paulo Date: 2014 Jul-Aug Impact factor: 1.846
Authors: Thiago Nascimento do Prado; Jayant V Rajan; Angélica Espinosa Miranda; Elias Dos Santos Dias; Lorrayne Beliqui Cosme; Lia Gonçalves Possuelo; Mauro N Sanchez; Jonathan E Golub; Lee W Riley; Ethel Leonor Maciel Journal: Braz J Infect Dis Date: 2016-12-06 Impact factor: 3.257