...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>BMC Infectious Diseases >Does directly observed therapy improve tuberculosis treatment? More evidence is needed to guide tuberculosis policy
【24h】

Does directly observed therapy improve tuberculosis treatment? More evidence is needed to guide tuberculosis policy

机译：是否直接观察治疗改善结核病治疗？需要更多的证据来指导结核病政策

获取原文
   

获取外文期刊封面封底 >>

       
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Background Tuberculosis (TB) now ranks alongside HIV as the leading infectious disease cause of death worldwide and incurs a global economic burden of over $12 billion annually. Directly observed therapy (DOT) recommends that TB patients complete the course of treatment under direct observation of a treatment supporter who is trained and overseen by health services to ensure that patients take their drugs as scheduled. Though the current WHO End TB Strategy does not mention DOT, only “supportive treatment supervision by treatment partners”, many TB programs still use it despite the fact that the has not been demonstrated to be statistically significantly superior to self-administered treatment in ensuring treatment success or cure. Discussion DOT is designed to promote proper adherence to the full course of drug therapy in order to improve patient outcomes and prevent the development of drug resistance. Yet over 8 billion dollars is spent on TB treatment each year and thousands undergo DOT for all or part of their course of treatment, despite the absence of rigorous evidence supporting the superior effectiveness of DOT over self-administration for achieving drug susceptible TB (DS-TB) cure. Moreover, the DOT component burdens patients with financial and opportunity costs, and the potential for intensified stigma. To rigorously evaluate the effectiveness of DOT and identify the essential contributors to both successful treatment and minimized patient burden, we call for a pragmatic experimental trial conducted in real-world program settings, the gold standard for evidence-based health policy decisions. It is time to invest in the rigorous evaluation of DOT and reevaluate the DOT requirement for TB treatment worldwide. Summary Rigorously evaluating the choice of treatment supporter, the frequency of health care worker contact and the development of new educational materials in a real-world setting would build the evidence base to inform the optimal design of TB treatment protocol. Implementing a more patient-centered approach may be a wise reallocation of resources to raise TB cure rates, prevent relapse, and minimize the emergence of drug resistance. Maintaining the status quo in the absence of rigorous supportive evidence may diminish the effectiveness of TB control policies in the long run.
机译：背景技术结核病（TB）现在以艾滋病毒为全世界死亡的主要传染病导致，并在每年招收全球经济负担超过120亿美元。直接观察到的治疗（DOT）建议TB患者在直接观察卫生服务培训和监督的治疗支持者下完成治疗过程，以确保患者按计划服用其药物。虽然目前的结核病战略没有提到DOT，但只有“通过治疗合作伙伴的支持性治疗监督”，仍然仍然使用它尽管尚未证明尚未证明在确保治疗方面的自我管理治疗统计学显着优势成功或治愈。讨论点旨在促进适当的粘附依赖于药物治疗的全部过程，以改善患者结果并防止耐药性的发展。然而，在TB治疗中，每年都花费超过80亿美元，尽管没有严格的证据表明，缺乏支持DOT对实现药物易感结核病的自我管理的卓越有效性（DS- TB）治愈。此外，DOT组件负担金融和机会成本的患者，以及加强耻辱的可能性。为了严格评估DOT的有效性，并确定成功治疗和最小化患者负担的基本贡献者，我们呼吁在现实世界方案设置中进行务实的实验试验，这是基于证据的卫生政策决策的黄金标准。是时候投资于对点的严格评估，并重新评估全世界TB治疗的点要求。摘要严格评估了治疗支持者的选择，医疗工作者的频率联系和新教育材料在真实环境中的开发将建立证据基础，以通知TB治疗方案的最佳设计。实施更符合患者以患者为中心的方法可能是提高TB治愈率，防止复发，并最大限度地减少耐药性的耐药性的明智权分配。在没有严格的支持性证据的情况下保持现状可以减少长期TB控制政策的有效性。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号