Drug-resistant tuberculosis treatment

Patient education or educational counselling. Analysis of the benefit of patient education included 
RCTs (173–176) and an observational study (184). Based on an assessment of the certainty of the 
evidence, carried out using predefined criteria and documented in GRADEpro, the certainty of the 
evidence was rated as very low to moderate depending on the outcome being assessed and type 
of study. Patients who received education or educational counselling had better rates of treatment 
success, treatment completion, cure and treatment adherence, and had lower rates of loss to 
follow-up. It should be noted in this case that “counselling” refers to educational counselling and not 
psychological counselling. Patient education could include oral or written education via health care 
workers or pharmacists. The education could be one-time at discharge from the intensive phase of 
therapy or at each presentation for follow-up care. The educational session might include only the 
health care worker or it might involve the patients’ social network and family members. It is important 
to make sure that education and counselling are done in a culturally appropriate manner. Additionally, 
specific marginalized populations may require special educational
efforts.

---

Recommendations 
68
Staff education. Staff education may include peer training, visual aids to help initiate conversations 
with patients, other tools to aid in decision-making and as reminders, and the education of laboratory 
staff. This intervention was examined in both RCTs and observational studies (177, 178, 227, 228). 
Based on an assessment of the certainty of the evidence, carried out using predefined criteria and 
documented in GRADEpro, the certainty of the evidence was rated as very low to moderate, depending 
on the outcome being assessed and type of study. There were higher rates of treatment success and 
slightly lower rates of mortality and loss to follow-up with staff education. With better staff education, 
treatment for patients is likely to improve and any stigma that health care workers may hold towards 
patients would decrease, as health care workers better understand TB disease and TB
treatment.