DIRECTLY OBSERVED THERAPY DOT for Patients prescribed TB Treatment Information for health practitioners responsible fo

1. DIRECTLY OBSERVED THERAPY (DOT)for Patients prescribed TB TreatmentInformation for health practitioners responsible for the supervision of DOT

2. Purpose of Directly Observed Therapy for TB Patients To provide extra support to patients to assist with the administration of TB treatment. To provide the correct dosage of TB drugs at the same time each day, without missing any doses. Successful treatment and cure of TB disease.

3. Background Information Every patient (public or private) diagnosed with TB disease in Queensland is monitored by the Qld TB Control Centre (QTBCC) Every patient (public or private) diagnosed with TB disease in Queensland has an allocated QTBCC or Regional TB Control Unit (RTCU) case nurse looking after them for the duration of the TB treatment Directly Observed Therapy (DOT) is prescribed for clients who demonstrate they may be incapable, unreliable or unwilling to take TB drugs. The decision to use DOT for a client is made by the treating Medical Officer (MO) and/or case nurse. The Supervised Treatment Form must be completed and signed by the treating Medical Officer with medications, dosages and expected dates of supervised therapy documented (daily or thrice weekly).

4. Process of DOT The supervisor should ideally be a health professional but other supervisors may be used as appropriate provided education is given. A place and approximate time (same time each day) is to be negotiated that is acceptable and convenient to the patient and supervisor. The supervisor must observe the patient taking and ingesting the TB drugs.

5. Process of DOT (continued) The supervisor must initial, time and date the supervised treatment form directly following patients� ingestion of medication. Medication side effects and adverse reactions should be documented and appropriately reported to the treating MO. Issues of non-compliance (eg. client does not attend for medication) should be reported to the treating MO.

6. Additional Information DOT treatment must be administered at the same time each day and all medications must be taken at that time. Even a single failure from attendance should be followed up: attempt to locate client, identify reason for non-attendance, ensure medication dosage has been self-administered or supervised, otherwise record as default.

7. More important information Supervised treatment forms should be collected/submitted at each MO appointment. Completed Supervised treatment forms to be filed in client health record. Supervised chemotherapy is usually given daily or thrice weekly (intermittent). All other regimens should be discussed with the Director of Queensland Tuberculosis Control Centre or the appropriate Regional TB Control Unit.

8. More important information (contd) If intermittent DOT is administered, it should be clearly understood that missing one or two doses would require reassessment by the treating MO. If Supervised Treatment form is near completion or if medication supplies are low, inform treating MO to ensure continuity of documentation and supply of medication.

9. References QTBCC Policy: TB Drug Policy Supervised Treatment (Directly Observed Therapy) procedure Guidelines: QTBCC Recommendations for Treatment of TB Resources Queensland Tuberculosis Control Centre �Tuberculosis Medications�, Tuberculosis Fact Sheet No 2. Websites: http://qheps.health.qld.gov.au/tuberculosis http://www.health.qld.gov.au/health_professionals/default