Juan G, Lloret T, Perez C, Lopez P, Navarro R, Ramón M, Cortijo J, Morcillo E J
Department of Medicine, Faculty of Medicine, University of Valencia, Spain.
Int J Tuberc Lung Dis. 2006 Feb;10(2):215-21.
To compare directly observed treatment (DOT) of tuberculosis through pharmacy offices with self-administered treatment (SAT) in patients at risk for non-adherence.
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.
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 Euro per patient compared to SAT.
In patients at risk for non-adherence, DOT implemented through pharmacy offices was better than SAT; however, completion rates were still low.
比较通过药房实施的直接观察治疗（DOT）与自我给药治疗（SAT）对有治疗依从性风险患者的结核病治疗效果。
对有治疗依从性风险的患者（感染人类免疫缺陷病毒[HIV]、酗酒、使用非法药物、移民或无家可归状态和/或既往治疗失败）进行DOT前瞻性研究（1999 - 2002年）和SAT回顾性研究（1996 - 1998年）。DOT项目中的患者作为门诊患者每周在药房接受两次药物治疗，药房监督治疗依从性并为患者提供社会卫生支持。
DOT组和SAT组分别有101例和112例患者。两组的人口统计学和临床特征相似。在治疗依从性风险因素方面观察到差异（DOT组中移民更多，静脉吸毒者更少，与SAT组相比；P < 0.05）。在DOT组中，76例患者（75.2%）完成治疗并治愈，而SAT组中只有30例患者（26.7%）完成治疗并治愈（P < 0.001）。与SAT相比，实施DOT使每位患者的治疗成本增加了400欧元。
对于有治疗依从性风险的患者，通过药房实施的DOT优于SAT；然而，完成治疗率仍然较低。
