Directly observed treatment for tuberculosis in pharmacies compared with self-administered therapy in Spain

• Published in: The international journal of tuberculosis and lung disease Vol. 10; no. 2; pp. 215 - 221
• Main Authors: JUAN, G, LLORET, T, PEREZ, C, LOPEZ, P, NAVARRO, R, RAMON, M, CORTIJO, J, MORCILLO, E. J
• Format: Journal Article
• Language: English
• Published: Paris, France IUATLD 01.02.2006; Union internationale contre la tuberculose et les maladies respiratoires
• Subjects: Adolescent; Adult; Aged; Antitubercular Agents - therapeutic use; Bacterial diseases; Biological and medical sciences; Directly Observed Therapy - methods; Directly Observed Treatment; Drug Prescriptions - statistics & numerical data; Female; Human bacterial diseases; Human immunodeficiency virus; Humans; Infectious diseases; Male; Medical sciences; Middle Aged; Miscellaneous; Mycobacterium; Patient Compliance; Pharmacies - statistics & numerical data; Pharmacy Office; Pneumology; Prevention and actions; Prospective Studies; Public health. Hygiene; Public health. Hygiene-occupational medicine; Respiratory system : syndromes and miscellaneous diseases; Retrospective Studies; Self Administration - statistics & numerical data; Spain; Tuberculosis; Tuberculosis - drug therapy; Tuberculosis and atypical mycobacterial infections; Europe; Spain; Organization; Respiratory disease; directly observed treatment; Mycobacterial infection; Self administration; Infection; Drug compliance; Chemotherapy; Treatment; Tuberculosis; Bacteriosis; pharmacy office; Treatment compliance; Antituberculous agent; Drugstore; Comparative study; Pneumology
• ISSN: 1027-3719; 1815-7920

OBJECTIVES: To compare directly observed treatment (DOT) of tuberculosis through pharmacy offices with self-administered treatment (SAT) in patients at risk for non-adherence.METHODS: Prospective study for DOT (1999-2002) and retrospective study for SAT (1996-1998) in patients at risk for non-adherence (human immunodeficiency virus [HIV] infection, alcoholism, illicit drug use, immigrant or homeless status and/or previous failure to complete). Patients in the DOT programme received medication as out-patients twice a week in pharmacies that supervised adherence and provided socio-sanitary support to patients.RESULTS: There were 101 and 112 patients in the DOT and SAT groups, respectively. Demographic and clinical characteristics were similar in both groups. Differences were observed in risk factors for non-adherence (more immigrants and fewer intravenous drug users in the DOT vs. the SAT groups; P < 0.05). In the DOT group, 76 patients (75.2%) completed treatment and were cured compared to only 30 patients (26.7%) in the SAT group (P < 0.001). Implementation of DOT increased the cost of treatment by 400€ per patient compared to SAT.CONCLUSION: In patients at risk for non-adherence, DOT implemented through pharmacy offices was better than SAT; however, completion rates were still low.