Counselling for regular follow-up during the treatment

The continuum of counselling and care is essential to constantly motivate TB patients to take their full drug regimen and complete it in due course.  

Counselling is regularly given by counsellors, treatment supporters and all those involved with patient care and treatment.  

Counselling should start at the initial point of contact as soon as the diagnosis is established and continued during all visits: 

• By the patient to a health facility  
• By healthcare workers’ visit to the patients’ home  
• Through the national TB call centre (Nikshay Sampark) 

Key Points for Counsellors:

1. Counsellors must inform patients that regular monthly follow-up during their treatment is important to understand their TB treatment response and to determine if they have been cured. 
2. Counsellors should inform patients of the follow-up schedule, and follow up, via physical visits or telephone calls, with patients to verify that they have gone for their follow-up visits at these times: 

a. Clinical evaluation at the end of every 4 weeks of treatment 

b. Sputum examination at the end of each treatment phase i.e., intensive and continuation phase 

c. Long-term post-treatment follow up: Sputum examination, at an interval of 6 months, 12 months, 18 months and 24 months, and if suspected, referred for testing again.​ 

A counselling register is maintained for all patients for recording information about the patients’ situation and counselling services provided from the time of diagnosis till post-treatment follow-up period. 

Information to be Provided to Patients During Regular Monthly Follow-up 

• Nature and duration of treatment 
• Need for regular treatment/adherence 
• Information on the lab results, and the reliability of lab results  
• Consequences of irregular treatment or pre-mature cessation of treatment 
• Possible side effects of anti-TB drugs and management of side effects 
• Nutritional counselling (Nikshay Poshan Yojna) 
• Services under National TB Elimination Program (NTEP) and linkage to social protection schemes 
• Infection control precautions that are necessary, and re-assurance to the family against panic or unnecessary stigmatization of the patient 

Resources 

Guidelines for PMDT in India, 2021 

Assessment