Skip to main content

Free Content Directly observed therapy for tuberculosis in New York City: factors associated with refusal

Download Article:
(PDF 193.818359375 kb)
OBJECTIVES: To describe patients who utilize hospital-based directly observed therapy (DOT) programs and to describe factors that influence refusal of DOT.

METHODS: Retrospective analysis of patients diagnosed with tuberculosis through hospital admission in 1997 at 12 hospital sites with out-patient DOT programs. Data were obtained from hospital patient records and from the New York City Tuberculosis Case Registry.

RESULTS: Of 443 patients diagnosed with tuberculosis in 1997 at the 12 hospital sites and available and/or eligible for DOT, 52 (12%) refused DOT. The two main reasons for DOT refusal were that the patients felt they could self-medicate (21%) and that their work schedule interfered with a DOT program (19%). White non-Hispanic race/ethnicity was associated with refusal of DOT (P = 0.001). Conversely, interview for DOT while in the hospital (P < 0.001) and enrollment in drug treatment were associated with acceptance of DOT (P = 0.05). The five hospitals with tuberculosis clinics on site had the lowest percentages (0–9%) of patients refusing DOT.

CONCLUSION: To increase patient acceptance of DOT, programs need flexible hours that accommodate patients in the workforce. Patient education should focus on the difficulty of completing tuberculosis treatment on a self-administered regimen and the importance of the support offered through DOT.
No References
No Citations
No Supplementary Data
No Data/Media
No Metrics

Keywords: New York City; directly observed therapy; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Public Health Laboratory Service, Communicable Disease Surveillance Centre, London, UK 2: Bureau of Communicable Disease, New York City Department of Health, New York, New York, USA

Publication date: 2004-04-01

More about this publication?
  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

  • Editorial Board
  • Information for Authors
  • Subscribe to this Title
  • International Journal of Tuberculosis and Lung Disease
  • Public Health Action
  • Ingenta Connect is not responsible for the content or availability of external websites
  • Access Key
  • Free content
  • Partial Free content
  • New content
  • Open access content
  • Partial Open access content
  • Subscribed content
  • Partial Subscribed content
  • Free trial content
Cookie Policy
Cookie Policy
Ingenta Connect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more