III. RELIABLE PATIENTS - A POTENTIAL RESOURCE FOR REDUCING THE ADHERENCE PROBLEM

A Cochrane database review found DOT to be no better than SAT in 10 trials. (Volmink and Garner 2006) Neither this review, nor other randomized controlled trials has studied the development of drug resistance in DOT vs. SAT regimens. (Rusen et al. 2007) Because multiple visits per week to a health facility requires significant patient motivation one might speculate that many if not most of the successful DOT patients could have been successfully treated with SAT. Another study showed DOT to be less cost effective than SAT. (Khan et al. 2002) In two resource limited programs 60% to 65% of patients were successfully treated with SAT. (Zwarenstein et al. 1998; Walley et al. 2001) These adherent patients represent a large potential resource for expanding TB treatment services, if they could be reliably identified.
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SUMMARY

I. INTRODUCTION

II. THE SUCCESS AND PROBLEMS WITH DOT

III. RELIABLE PATIENTS - A POTENTIAL RESOURCE FOR REDUCING THE ADHERENCE PROBLEM

IV. DETERMINING THE ADHERENCE OF PATIENTS

V. EXPERIENCE WITH SELF ADMINISTERED TREATMENT GIVEN IN MEDICATION MONITORS (MONITORED SAT)

VI. PROPOSED SUPERVISION OF TREATMENT BASED ON MONITORED SAT AND DOT GIVEN SELECTIVELY

VII. USE OF MONITORED SAT TO IMPROVE TREATMENT OUTCOMES AND EXPAND SERVICES IN VARIOUS SETTINGS

VIII. CAN MEDICATION MONITORS HELP PREVENT DRUG RESISTANT DISEASE

IX) USE OF MEDICATION MONITORS WHEN MANAGING HIV/AIDS and HIV/AIDS/TB

X) EXPENSE AND PRACTICALITY OF USING MEDICATION MONITORS

XI. EVALUATION

XII. IN SUM

REFERENCES:

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