Enhancing patient compliance with tuberculosis therapy.

A major determinant of the outcome of tuberculosis treatment is patient compliance; nevertheless, 20 to 50 per cent of patients fail to complete therapy. The consequences of failure to complete therapy include prolonged communicability, relapse, prolonged and more expensive therapy, development of drug resistance, and death. Noncompliance is a significant factor leading to the persistence of tuberculosis in the United States. Although one-to-one counseling offers the greatest impact for improving compliance, other strategies, such as the use of enablers, incentives, and directly observed therapy, are important as well.