Drug-resistant tuberculosis treatment
Recommendations in the 2019 updat
Download 1.73 Mb. Pdf ko'rish
|
9789240007048-eng
- Bu sahifa navigatsiya:
- Recommendations in the 2019 updat e Recommendations in the curr ent updat e
- World Health Organization
|
Recommendations in the 2019 updat
e Recommendations in the curr ent updat e One or mor e o f the following tr eatment adher ence inter ventions (complementar y and not mutually exclusive) may be o ffer ed to patients on TB tr eatment or to health-car e pr ovider s: a. tracer s 73 and/or digital medication monitor 74 (conditional recommendation, ver y low cer tainty in the evidence); b. material suppor t 75 to the patient (conditional r ecommendation, moderate cer tainty in the evidence); c. psychological suppor t 76 to the patient (conditional recommendation, low cer tainty in the evidence); d. staff education (conditional r ecommendation, low cer tainty in the evidence). 77 8.3 One or mor e o f the following tr eatment adher ence inter ventions (complementar y and not mutually exclusive) may be o ffer ed to patients on TB treatment or to health car e pr ovider s: a. tracer s 73 and/or digital medication monitor 74 (conditional r ecommendation, ver y low cer tainty in the evidence); b. material suppor t 75 to the patient (conditional r ecommendation, moderate cer tainty in the evidence); c. psychological suppor t 76 to the patient (conditional r ecommendation, low cer tainty in the evidence); d. staff education 77 (conditional r ecommendation, low cer tainty in the evidence). (no change) 73 Tracer s r efer to communication with the patient, including home visits or via shor t message ser vice (SMS), telephone (voice) call. 74 A digital medication monitor is a device that can measur e the time between openings o f the pill bo x. The medication monitor can have audio r eminder s or send an SMS to r emind the patient to take medications, along with r ecor ding when the pill bo x is opened. 75 Material suppor t can be food or financial suppor t: meals, food baskets, food supplements, food voucher s, transpor t subsidies, living allowance, housing incentives or financial bonus. This suppor t addr esses the indir ect costs incurr ed by patients or their attendants in or der to access health ser vices and, possibly , tries to mitigate the consequences o f income loss r elated to the disease. 76 Psychological suppor t can be counselling sessions or peer -gr oup suppor t. 77 Staff education can be adher ence education, char t or visual r eminder s, educational tools and desktop aids for decision-making and reminder s. Supplementary Table 98 Recommendations in the 2019 updat e Recommendations in the curr ent updat e The following tr eatment administration options may be o ffer ed to patients on TB treatment: a. Community- or home-based dir ectly-obser ved tr eatment (DO T) is r ecommended over health facility-based DO T or unsuper vised tr eatment (conditional r ecommendation, moderate cer tainty in the evidence). b. DO T administer ed by trained lay pr ovider s or health- car e worker s is r ecommended over DO T administer ed by family member s or unsuper vised tr eatment (conditional recommendation, ver y low cer tainty in the evidence). c. Video-obser ved tr eatment (V O T) may r eplace DO T when video communication technology is available, and it can be appr opriately or ganized and operated by health-car e pr ovider s and patients (conditional r ecommendation, ver y low cer tainty in the evidence). 8.4 The following tr eatment administration options may be o ffer ed to patients on TB treatment: a. Community- or home-based dir ectly obser ved tr eatment (DO T) is recommended over health facility-based DO T or unsuper vised tr eatment (conditional r ecommendation, moderate cer tainty in the evidence). b. DO T administer ed by trained lay pr ovider s or health car e worker s is recommended over DO T administer ed by family member s or unsuper vised treatment (conditional r ecommendation, ver y low cer tainty in the evidence). c. Video-obser ved tr eatment (V O T) may r eplace DO T when the video communication technology is available, and it can be appr opriately or ganized and operated by health car e pr ovider s and patients. (conditional recommendation, ver y low cer tainty in the evidence) (no change) Patients with MDR-TB should be tr eated using mainly ambulator y car e rather than models o f car e based principally on hospitalization (conditional r ecommendation, ver y low- quality evidence). 8.5 P atients with multidrug-r esistant TB (MDR-TB) should be tr eated using mainly ambulator y car e rather than models o f car e based principally on hospitalization. (Conditional r ecommendation, ver y low quality evidence). (no change) A decentralized model o f car e is r ecommended over a centralized model for patients on MDR-TB tr eatment (conditional recommendation, ver y low cer tainty in the evidence). 8.6 A decentralized model o f car e is r ecommended over a centralized model for patients on MDR-TB treatment. (Conditional r ecommendation, ver y low cer tainty in the evidence). (no change) WHO consolidated guidelines on tuber culosis Module 4: T reatment For further information, please contact: World Health Organization 20, Avenue Appia CH-1211 Geneva 27 Switzerland Global TB Programme Web site: www.who.int/tb Document Outline
Download 1.73 Mb. Do'stlaringiz bilan baham: 
|