A program to increase the participation rate in DOTS (Direct Observed Treatment, Short course) of Tuberculosis patients in the community

Abstract

Tuberculosis (TB), a disease subject to mandatory reporting, is widely distributed in our country. The Direct Observed Treatment, Short-course (DOTS) is an effective protocol to increase TB treatment success. We developed a program in our hospital to increase discharged patient participation in DOTS, which helps ensure they receive 6 to 9 months of post-discharge medication therapy to maximize treatment outcomes. We identified four key problems related to low TB patient participation in DOTS. These included (1) patients did not understand the DOTS program; (2) staff did not know how to conduct the DOTS protocol; (3) staff had not received in-service DOTS education; and (4) the hospital had no DOTS patient education or teaching aids available. To improve TB patient participation in DOTS, we revised patient education material, provided continuing education to nursing staff, invited physicians and community co-workers to join in the outreach program, and made posters to remind discharged patients to sign up for the DOTS program. Patient participation in DOTS rose from 27.1% to 96.3% and nursing staff knowledge of DOTS rose from 86.3% to 100%. This program effectively increased TB patient motivation to join DOTS after hospital discharge and also improved successful recovery and treatment completion rates. Increasing post-discharge TB patient participation in the DOTS protocol is an effective strategy for achieving the national goal of reducing TB cases by 50% within ten years.