Monitoring and Improving Adherence to Tuberculosis Medications

LetsTalkTB_1Authors: Ramnath Subbaraman, MD, MSc, FACP and Amrita Daftary, PhD, MPH
Number of pages: 10
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Overview: Today, about 10% to 50% of all TB patients in India fail to complete treatment, depending on the type of TB the patient has. The consequences of poor adherence to TB treatment are disastrous, increasing the risk of patient morbidity and mortality, disease relapse, drug-resistance, and transmission of TB. While the Revised National TB Control Programme (RNTCP) has long relied upon direct observation of therapy (DOT) for TB patients, this monitoring strategy requires greater resources than are available to most GPs. New technologies for monitoring medication adherence—including cellphone-based strategies and electronic pillboxes—may soon become available to GPs in parts of India and provide alternative strategies for monitoring pill-taking by patients in real time. Once a GP identifies medication non-adherence, she or he should screen for and address toxicities from TB medications, poor nutrition and other comorbidities (e.g., HIV, diabetes), psychosocial barriers (e.g., depression, stigma, substance use disorders) and poor treatment literacy that could be contributing to non-adherence. Improving TB medication adherence therefore requires an interdisciplinary approach.

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