compliance

Last reviewed 01/2018

The importance of compliance must be stressed to the patient.

• patient adherence to appropriate drug treatment is a major determinant of treatment success
  • if there has been good adherence with the appropriate drug regimen, relapse is uncommon in those with fully drug-sensitive TB (0–3%) - thus treatment failure or relapse in patients who have been prescribed an effective regimen is usually caused by poor adherence
• to aid patient adherence with daily therapy, combined drug preparations are recommended (1).
• rifampicin preparations impart an orange-red colour to bodily secretions and fluid, including urine, and this can serve as an indication of whether patients are taking their medication.
• directly-observed therapy (DOT) is currently recommended for those patients who, due to their circumstances and/or underlying conditions, may be less likely to adhere to selfmedication
  • these include the homeless, those who abuse alcohol and drugs, the mentally ill, and refugees and asylum seekers
  • DOT involves a health professional or a responsible person witnessing patients taking each dose of their anti-TB medication - DOT can be either hospital- or community-based, and primary care health professionals need to know if their patients are involved in such a programme so they can help supervise adherence and follow-up

Note that termittent drug regimens may be used in DOT programmes, in which patients take modified drug doses three times a week, rather than standard daily doses.

Reference:

1. MeReC bulletin (2003); 14 (3):9-12.