Poster: Helping TB Patients to adhere to treatment

TB patients are more likely to take their treatment correctly and complete it when they feel that you have heard and understood their concerns and taken these into account when developing a treatment plan.

To do this, you need to:

Make sure patients understand TB and its treatment:

• Ask what they know about TB and its treatment
• Explain how the TB bacteria affects the body and how TB treatment works
• Ask how they feel and what concerns they have about taking treatment
• Explain why it is important to take the full course of treatment as prescribed
• Explain the common side-effects of treatment and what to do when they experience these
• Explain that it is important to inform you as soon as possible if they experience side-effects

Find out about lifestyle and other factors that might impact on the patient’s adherence:

• Ask about any previous depression or other psychiatric conditions and note if this needs further attention
• Ask if they drink alcohol, smoke, or use drugs, and explain how this might affect their treatment
• Ask about their religious or traditional beliefs and if they follow any religious or traditional practices such as visiting traditional healers and explain how this might affect their treatment

Develop a treatment plan together:

• Agree on the treatment plan and how they will take the treatment
• Ask if there are any circumstances that might make it difficult to follow the treatment plan
• Discuss what to do in case of a missed dose, vomiting, extreme side-effects or in an emergency
• Explain how often they will need to return to the clinic to collect pills or for testing
• Ask about other medications they are taking and discuss possible drug interactions and any necessary changes to their medications

Ensure patients have the support they need:

• Ask about possible support structures at home and work and their socioeconomic circumstances
• Ask if they require assistance such as food programmes or access to a social grant
• Link them to a DOT supporter, community care giver or treatment supporter
• Suggest where they can find additional reliable information on TB
• Put together a package of pamphlets, leaflets or other written materials about TB that the patient can take home

Motivate patients to take treatment:

• Encourage them to list reasons they might have for getting healthy
• Encourage them to identify somebody who can support them through their treatment journey

Explain the importance of infection control:

• Ask them to bring in close contacts who may have been exposed to TB
• Explain the importance of practicing correct cough hygiene and how to help prevent passing TB on to others