Direct observation of treatment involves far more than “supervised swallowing” and works best when it builds a human bond between the patient and the treatment observer that acknowledges the value of successful treatment for the patient and for his or her community.
What is directly observed therapy?
Directly observed therapy (DOT) is used to ensure the person receives and takes all medications as prescribed and to monitor response to treatment. DOT is widely used to manage tuberculosis (TB) disease. In HIV treatment, DOT is sometimes called directly administered antiretroviral therapy (DAART). Directly Observed Therapy (DOT) | NIH
What is Directly Observed Treatment (DOT)?
The good news is that there is help – it’s called directly observed treatment – or DOT for short. What is DOT? DOT is a way of helping people during their treatment. Instead of being sent home with your tablets, you might visit your local hospital or pharmacy, or a nurse can come to your home.
Is there a role for direct observation in TB treatment?
Direct observation as a strategy is still debated in TB and other chronic diseases. These debates and the findings of this review and others are important given the often huge resource implications of implementing a direct observation therapy programme.
How many decision support techniques directly observed therapy?
MOTIVATION DECISION SUPPORT TECHNIQUES directly observed therapy 1 and 4 6 DECISION SUPPORT TECHNIQUES DOT* compliance 7 DOT*
What is the meaning of direct observed treatment?
A method of drug administration in which a health care professional watches as a person takes each dose of a medication. Directly observed therapy (DOT) is used to ensure the person receives and takes all medications as prescribed and to monitor response to treatment.
WHO directly observed therapy?
Directly Observed Therapy (DOT) is a specific strategy, endorsed by the World Health Organization, to improve adherence by requiring health workers, community volunteers or family members to observe and record patients taking each dose.
What is video directly observed therapy?
Video Directly Observed Therapy (VDOT) is the use of a videophone or other video/computer equipment to observe tuberculosis (TB) patients taking their medications remotely. The method is promising as a flexible and less invasive option to help ensure TB patients complete their treatment successfully.
Who can discontinue direct observation therapy?
2) Only the patient's health care provider shall have the authority to order or discontinue DOT.
Why directly observed treatment is necessary?
DOT helps patients finish TB therapy as quickly as possible, without unnecessary gaps. DOT helps prevent TB from spreading to others. DOT decreases the risk of drug-resistance resulting from erratic or incomplete treatment. DOT decreases the chances of treatment failure and relapse.
What is directly observed therapy in Singapore?
Tuberculosis treatment – Directly Observed Therapy (DOT) Called Directly Observed Therapy (DOT), the treatment requires patients to go to a clinic daily or three times a week and take their medicine (about 11 tablets initially) in front of a health care worker, most often a nurse. The process is rather quick.
What is the program of TB DOTS?
The Problem: Tuberculosis is a treatable, infectious disease that is one of the leading causes of death for adults in the developing world. The Program: DOTS for TB consists of a) diagnosing cases, b) treating patients for 6-8 months with drugs, and c) promoting adherence to the relatively difficult treatment regimen.
How do you know if TB treatment is working?
After taking TB medicine for several weeks, a doctor will be able to tell TB patients when they are no longer able to spread TB germs to others. Most people with TB disease will need to take TB medicine for at least 6 months to be cured.
What happens if someone refuses TB treatment?
If a person does not comply with the terms and conditions of his conditional discharge, he shall be subject to any of the procedures for involuntary treatment, including but not limited to the issuance of an order for protective custody.
Which drugs are given in DOTS?
DOTS involved treatment with a four drug regimen. These were isoniazid (INH), Rifampicin (Rif), Prazinamide (PZA) and Ethambutol (EMB) for 6-9 months.
How long is a standardized treatment regimen?
Standardized treatment regimen directly of six to nine months observed by a healthcare worker or community health worker for at least the first two months. A standardized recording and reporting system that allows assessment of treatment results.
Who is the head of the Bureau of TB Control?
At the news conference, Tom Frieden, head of the city’s Bureau of TB Control captured the essence of DOTS, "TB control is basically a management problem.”. Frieden had been credited for using the strategy to turn around New York City’s TB outbreak a few years earlier.
How to stop the spread of TB?
According to WHO, "The most cost-effective way to stop the spread of TB in communities with a high incidence is by curing it. The best curative method for TB is known as DOTS.". DOTS has five main components:
What is a dot in TB?
For the brand of gumdrops, see Dots (candy). Directly observed treatment, short-course ( DOTS, also known as TB-DOTS) is the name given to the tuberculosis (TB) control strategy recommended by the World Health Organization. According to WHO, "The most cost-effective way to stop ...
How long does TB treatment last?
Government commitment (including political will at all levels, and establishment of a centralized and prioritized system of TB monitoring, recording and training) Standardized treatment regimen directly of six to nine months observed by a healthcare worker or community health worker for at least the first two months.
What is direct observed therapy?
Directly observed therapy. Concerns about patient adherence, its effects on relapse and the development of drug resistance, has lead to the WHO advocating directly observed therapy (DOT) in the form of short-course chemotherapy or DOTS.
What is DOT therapy?
DOT not only ensures administration of prescribed therapy for the benefit of community disease control but also provides a regular venue for detecting adverse effects, assessing response to therapy, and encouraging perseverance with drug regimens that are typically difficult to tolerate.
Why is ethambutol included in the regimen?
Ethambutol is included in the regimen in the event that drug resistance is later detected from the tuberculosis culture. If the offending organism is known to be susceptible to all antituberculous medications then ethambutol can be excluded.
How did the discovery of tuberculosis affect the lives of millions of people?
The discovery and widespread use of these drugs dramatically changed the lives of millions of people. The tuberculosis sanatorium, which offered patients the comfort of bed rest and helped diminish tuberculosis transmission in the community, long the only hope for many patients, soon became obsolete.
What is DOT in healthcare?
DOT is a service provided by healthcare departments in which a trained public health worker watches the ingestion of each dose of medication taken to complete therapy.
Can you take DOT daily?
With this method of treatment, the ingestion of every dose is monitored by a nursing or lay observer. DOT can be given daily but an intermittent regimen, with appropriate dos age adjustments, is often more convenient as doses can be scheduled to avoid weekends.
Is DOT a public health standard?
While work remains to be done to better specify the elements of treatment support that are most important for good clinical and public health outcomes, DOT remains a public health standard of care for treatment of tuberculosis, especially in the setting of multidrug resistance.
What is visual monitoring?
visual monitoring by a health care worker of patients' ingestion of medications, to ensure compliance in difficult or long-term regimens, such as in oral treatment for tuberculosis; a contentious aspect of some WHO programs.
Why is DOT important?
important in treating patients with infectious diseases (e.g., HIV/AIDS or tuberculosis) in which development of drug-resistant microorganisms is likely to threaten public health if the drug is not taken exactly as prescribed.
What is visual monitoring?
visual monitoring by a health care worker of patients' ingestion of medications, to ensure compliance in difficult or long-term regimens, such as in oral treatment for tuberculosis; a contentious aspect of some WHO programs.
Why is DOT important?
important in treating patients with infectious diseases (e.g., HIV/AIDS or tuberculosis) in which development of drug-resistant microorganisms is likely to threaten public health if the drug is not taken exactly as prescribed.
When should DOT be initiated?
DOT should be initiated when TB treatment starts. Do not allow the patient to try self-administering medications and missing doses before providing DOT. If the patient views DOT as a punitive measure, there is less chance of successfully completing therapy.
Who provides DOT?
A nurse or supervised outreach worker from the patient's county public health department normally provides DOT. In some situations, it works best for clinics, home care agencies, correctional facilities, treatment centers, schools, employers, and other facilities to provide DOT, under the guidance of the local health department.
Why do we need a dot?
DOT helps patients finish TB therapy as quickly as possible, without unnecessary gaps. DOT helps prevent TB from spreading to others. DOT decreases the risk of drug-resistance resulting from erratic or incomplete treatment. DOT decreases the chances of treatment failure and relapse.
Do home care agencies provide DOT?
DOT providers must remain objective. For complex regimens including IV/IM medications or twice daily dosing, home care agencies may provide DOT or share responsibilities with the local health department . If resources for providing DOT are limited, priority should be given to patients most at risk.