| Titre : | Directly observed therapy and treatment adherence. (2000) |
| Auteurs : | J. VOLMINK ; P. GARNER ; P. MATCHABA ; South African Cochrane Centre. Medical Research Council. Tygerberg Cape Town. ZAF |
| Type de document : | Article |
| Dans : | Lancet (The) (vol. 355, n° 9212, 2000) |
| Pagination : | 1345-1350 |
| Langues: | Anglais |
| Mots-clés : | Tuberculose ; Bactériose ; Infection ; Poumon ; Observance thérapeutique ; Surveillance ; Thérapeutique ; Etude comparée ; Homme ; Appareil respiratoire [pathologie] ; Tuberculose pulmonaire |
| Résumé : | [BDSP. Notice produite par INIST S0R0xx33. Diffusion soumise à autorisation]. Direct observation of patients taking their medication is a strategy to Improve completion rates for tuberculosis treatment, but the programmes to implement this approach consist of a complex array of inputs aimed at influencing adherence. Policy makers need a clear understanding of these Inputs to succeed. We systematically identified and reviewed published reports of direct observation therapy (DOT) programmes and compared Inputs with WHO's short-course DOT programme. DOT programmes frequently consist of more than the five elements of WHO's strategy, Including Incentives, tracing of defaulters, legal sanctions, patient-centred approaches, staff motivation, supervision, and additional external funds. Focusing on direct observation as a key factor in the promotion of adherence seems inappropriate. Multiple components might account for the success of DOT programmes, and WHO should make these explicit. |
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