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Free Content City tuberculosis control coordinators' perspectives of patient adherence to DOT in São Paulo State, Brazil, 2005

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SETTING: Thirty-six priority cities in São Paulo State, Brazil, with a high incidence of tuberculosis (TB) cases, deaths and treatment default.

OBJECTIVE: To identify the perspectives of city TB control coordinators regarding the most important components of adherence strategies adopted by health care teams to ensure patient adherence in 36 priority cities in the State of São Paulo, Brazil.

DESIGN: Qualitative research with semi-structured interviews conducted with the coordinators of the National TB Control Programme involved in the management of TB treatment services in the public sector.

RESULTS: The main issues thought to influence adherence to directly observed treatment (DOT) by coordinators include incentives and benefits delivered to patients, patient-health care worker bonding and comprehensive care, the encouragement given by others to follow treatment (family, neighbours and health professionals), and help provided by health professionals for patients to recover their self-esteem.

CONCLUSION: The main aspects mentioned by city TB control coordinators regarding patient adherence to treatment and to DOT in São Paulo are improvements in communications, relationships based on trust, a humane approach and including the patients in the decision-making process concerning their health.
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Keywords: DOT; bonding; health planning; patient adherence; tuberculosis

Document Type: Regular Paper

Affiliations: 1: College of Nursing, University of São Paulo at Ribeirão Preto, São Paulo, Brazil; and Brazilian TB Research Network–REDE-TB, Ribeirão Preto, São Paulo, Brazil 2: Brazilian TB Research NetworkÐREDE-TB, Ribeirão Preto, São Paulo, Brazil 3: School of Medicine, University of São Paulo at Ribeirão Preto, São Paulo, Brazil 4: College of Nursing, University of São Paulo at Ribeirão Preto, São Paulo, Brazil

Publication date: May 1, 2008

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  • 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 lung health world-wide.

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