G_CS_07 Direct Observed Therapy (DOT) to Patients with Tuberculosis (TB) Disease or Latent TB Infection (LTBI)

Countywide guidance on the administration of Direct Observed Therapy (DOT) to patients with Tuberculosis (TB) Disease or Latent TB Infection (LTB I).

Tuberculosis (TB) is a largely curable infection if individuals with the disease have access to, and are able to adhere to effective treatment regimes.

Directly Observed Therapy (DOT) is a standard of care for tuberculosis (TB) treatment. It is a labour intensive process requiring the trained health care worker to, amongst other procedures; observe or administer the patient taking each dose of TB medication. When TB patients receive all medications as prescribed under a programme of DOT, both patients and community benefit.

The purpose of the guidance is to: Define and establish the role of DOT as a standard of care, integral to the case management of TB/ Latent TB infection patients (LTBI), Provide a uniform countywide approach to the administration of DOT, Advise on the appropriately applied DOT process, Ensure adherence to local medicines management processes, Advise on effective promotion of treatment compliance and completion.  This guidance will be supported by local processes, dependant upon the place of administration and resources available e.g. GP surgery, Community Base, Home.

The recommendations in this policy are based on: Department of Health 2007 Tuberculosis preventing and treatment: a toolkit for planning, commissioning and delivering high quality services in England and NICE 2011 CG117 Clinical diagnosis and management of tuberculosis and its measures for prevention and control, NICE 2012, CG 37 Identifying and managing tuberculosis among hard to reach groups.

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