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Treatment Adherence for individuals taking TPT
Learning ObjectivesThe learner will be able to
- Discuss the significance of Treatment Adherence for individuals taking TPT
- State the criteria for completion of TPT among contacts of persons with DR-TB
H5Content
Content
Adherence to the Tuberculosis Preventive Treatment (TPT) course and treatment completion are important determinants of clinical benefit, both at individual and population levels.
- Develop a personal adherence plan with the support of the family member, caregiver or health worker as per the treatment regimen being provided.
- Treatment support and adherence monitoring will be like that of the index patient.
- Give first preference to the family member to be the treatment provider in consultation with the person.
- Use of digital platforms (tele/ video calls, 99DOTS/ MERM), counting empty blisters, refill monitoring etc., to strengthen adherence monitoring.
- Irregular or inadequate treatment reduces the protective efficacy of TPT regimen.
- Poor adherence or early cessation of TPT can potentially increase the risk of the individual developing TB including Drug-resistant Tuberculosis (DR-TB) (although not supported by existing evidence from research settings).
- It is known that the efficacy of TPT is greatest if at least 80% of the doses are taken within the duration of the regimen. The total number of doses taken is also a key determinant of the extent of TB prevention.
The criteria for completion of TPT among DR-TB contacts have been given in the table below.
DOSES | TOTAL DURATION IN MONTHS | EXPECTED NO. OF DOSES | 80% OF RECOMMENDED DOSES (DAYS) | EXTENDED TIME FOR TREATMENT COMPLETION (DAYS) (TREATMENT DURATION + 33% ADDITIONAL TIME) |
---|---|---|---|---|
6Lfx (daily) | 6 | 180 | 144 | 239 |
4R (daily) | 4 | 120 | 96 | 160 |
Resources
- Guidelines for Programmatic Management of Drug-resistant Tuberculosis in India, 2021.
- WHO Consolidated Guidelines on Tuberculosis: Module 1: Prevention: Tuberculosis Preventive Treatment, 2020.
- Latent TB Infection: Updated and Consolidated Guidelines for Programmatic Management, World Health Organization, 2018.
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Criteria for completion of…
Dr. Priyadarshini Sat, 24/02/2024 - 07:10
Criteria for completion of TPT among contacts of persons with DR-TB can be a separate content page