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Dot by dot vs full5/17/2023 Curry National Tuberculosis Center and the New York City Department of Health.ġ. Adopt and reflect a nonjudgmental attitude.įor further information or assistance making referrals for DOT, contact the Minnesota Department of Health, TB Prevention and Control Program, 65.Īdapted from materials from the Francis J.Avoid criticizing the patient's behavior respectfully offer helpful suggestions for change.How can a DOT provider build rapport and trust? Patients taking daily therapy can usually self-administer their weekend doses.connecting patients with social services or transportation.helping patients keep medical appointments.DOT works best when used with a patient-centered case management approach, including such things as:.The DOT provider should reinforce this message. The prescribing physician should show support for DOT by explaining to the patient that DOT is widely used and very effective.If the patient views DOT as a punitive measure, there is less chance of successfully completing therapy. Do not allow the patient to try self-administering medications and missing doses before providing DOT. DOT should be initiated when TB treatment starts.watching the patient swallow the medication.See the MDH DOT Risk Assessment form for help identifying high-priority patients. If resources for providing DOT are limited, priority should be given to patients most at risk. For complex regimens including IV/IM medications or twice daily dosing, home care agencies may provide DOT or share responsibilities with the local health department.Family members should not be used for DOT.In some situations, it works best for clinics, home care agencies, correctional facilities, treatment centers, schools, employers, and other facilities to provide DOT, under the guidance of the local health department.A nurse or supervised outreach worker from the patient's county public health department normally provides DOT.DOT decreases the chances of treatment failure and relapse.DOT decreases the risk of drug-resistance resulting from erratic or incomplete treatment. DOT helps prevent TB from spreading to others.DOT helps patients finish TB therapy as quickly as possible, without unnecessary gaps.Studies show that 86-90% of patients receiving DOT complete therapy, compared to 61% for those on self-administered therapy.People from all social classes, educational backgrounds, ages, genders, and ethnicities can have problems taking medications correctly. We cannot predict who will take medications as directed, and who will not.What is DOT?ĭOT means that a trained health care worker or other designated individual (excluding a family member) provides the prescribed TB drugs and watches the patient swallow every dose. DOT is especially critical for patients with drug-resistant TB, HIV-infected patients, and those on intermittent treatment regimens (i.e., 2 or 3 times weekly). National TB treatment guidelines strongly recommend using a patient-centered case management approach - including directly observed therapy ("DOT") - when treating persons with active TB disease. The Video DOT Tool Kit for Local Public Health is now available!ĭownload PDF version formatted for print:ĭirectly Observed Therapy (DOT) for the Treatment of Tuberculosis (PDF) Directly Observed Therapy (DOT) for the Treatment of Tuberculosisįact sheet describing how to use DOT with TB patients.
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