B L Davidson1. 1. City of Philadelphia Department of Public Health, Tuberculosis Control Program, Allegheny University of the Health Sciences, PA, USA. brucedavidson@pobox.com
Abstract
STUDY OBJECTIVES: To compare treatment completion rates at 8 and 12 months after treatment initiation for patients with active TB treated with either directly observed therapy (DOT) or self-administered therapy (SAT). DESIGN: Retrospective comparison study of DOT and SAT concurrent patient cohorts. SETTING: Urban Tuberculosis Control Program within a Department of Public Health. PATIENTS: Three hundred nineteen patients confirmed to have active TB between July 1, 1994, and June 30, 1995, who began outpatient drug therapy. INTERVENTIONS: Patients and/or their physicians chose to receive their anti-TB drug therapy by DOT (n=113) or SAT (n=206) and were assessed for treatment completion at prospectively determined times, 8 and 12 months. MEASUREMENTS AND RESULTS: Proportions of patients who completed treatment at 8 and 12 months without crossing over to the other group were compared. At 8 months, 52% of DOT and 35% of SAT patients had completed treatment (relative superiority of DOT, 49%; p=0.003). At 12 months, completion rates were 70% for DOT patients and 53% for SAT patients (relative superiority of DOT, 30%; p=0.006). CONCLUSIONS: In our setting, patients receiving DOT were much more likely to complete treatment earlier than those receiving SAT. Even with DOT, only 52% of patients had completed treatment by 8 months.
STUDY OBJECTIVES: To compare treatment completion rates at 8 and 12 months after treatment initiation for patients with active TB treated with either directly observed therapy (DOT) or self-administered therapy (SAT). DESIGN: Retrospective comparison study of DOT and SAT concurrent patient cohorts. SETTING: Urban Tuberculosis Control Program within a Department of Public Health. PATIENTS: Three hundred nineteen patients confirmed to have active TB between July 1, 1994, and June 30, 1995, who began outpatient drug therapy. INTERVENTIONS:Patients and/or their physicians chose to receive their anti-TB drug therapy by DOT (n=113) or SAT (n=206) and were assessed for treatment completion at prospectively determined times, 8 and 12 months. MEASUREMENTS AND RESULTS: Proportions of patients who completed treatment at 8 and 12 months without crossing over to the other group were compared. At 8 months, 52% of DOT and 35% of SAT patients had completed treatment (relative superiority of DOT, 49%; p=0.003). At 12 months, completion rates were 70% for DOT patients and 53% for SAT patients (relative superiority of DOT, 30%; p=0.006). CONCLUSIONS: In our setting, patients receiving DOT were much more likely to complete treatment earlier than those receiving SAT. Even with DOT, only 52% of patients had completed treatment by 8 months.
Authors: Katharine E Schmitz; Melbourne F Hovell; Charlene A Wong; Norma J Kelley; Donata Nilsen; Elaine J Blumberg; Linda L Hill; Carol L Sipan; Bo Kolody; Dale A Chatfield Journal: Clin Nurs Res Date: 2010-05 Impact factor: 2.075