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Topic: Directly observed therapy

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	Making DOT Work
		Recently several large urban cities have demonstrated that providing directly observed therapy (DOT) in the treatment of tuberculosis (TB) has resulted in substantial decreases in TB cases.
		DOT can take place in the office, clinic, or in the community and can be used alone or with other measures.
		Success in DOT depends on an outreach worker's ability to problem solve, facilitate and empathize with his or her client.
	www.umdnj.edu /~ntbcweb/mdotw.htm (964 words)

	Tuberculosis: Treatment and Antibiotic Resistance (Site not responding. Last check: 2007-09-08)
		Directly observed therapy allows therapy to be more feasible and more cost efficient than a daily regimen.
		Directly observed therapy has been found to be more effective than self-administered therapy.
		While a person is receiving drug therapy for tuberculosis it is important to monitor for compliance, treatment response, toxicity development, and signs of treatment failure.
	www.goshen.edu /bio/Biol206/Biol206LabProject/tricia/tbtx.html (612 words)

	SD TB therapy
		Directly observed therapy (DOT) is defined as “a strategy devised to help patients adhere to treatment for active TB.
		Directly observed therapy is provided to all active TB cases by South Dakota Department of Health staff or by contractual TB Outreach Workers unless otherwise directed by the patient’s attending physician.
		Directly observed preventive therapy (DOPT) is a supervised course of therapy which is therapy provided to patients for treatment of latent TB (not active TB).
	www.state.sd.us /doh/TB/therapy.htm (185 words)

	DOT for HAART: Directly Observed Therapy - The Body
		Directly observed therapy (DOT) refers to the taking of medications in the presence of a medical provider, either in the provider's office or at the patient's home, so the provider can actually watch the pills being swallowed.
		In an antiretroviral-experienced population, although DOT achieved an impressive 99 percent adherence rate, only two-thirds of the residents achieved an undetectable viral load and 41 percent had a treatment failure at least once, regardless of their regimen.
		DOT for HAART may be more cost-effective and ultimately more successful in resource-poor settings where the cost of antiretrovirals is relatively high, especially when compared to the cost of personnel.
	www.thebody.com /step/fall02/dot.html (1564 words)

	Directly Observed Therapy : Bureau of Tuberculosis Control : NYC DOHMH
		Directly Observed Therapy (DOT) is the standard of care for tuberculosis (TB) treatment.1 In directly observed therapy, a trained health care worker monitors the patient taking each dose of anti-tuberculosis medication.
		DOT can prevent the transmission of TB and help safeguard patients on regimens that pose a high risk of drug interactions.
		The effect of directly observed therapy on the rates of drug resistance and relapse in tuberculosis.
	home.nyc.gov /html/doh/html/tb/tb2a.shtml (651 words)

	APHA - American Journal of Public Health - July 1998 Abstracts - Tuberculosis (Site not responding. Last check: 2007-09-08)
		This study examined the relationship between directly observed therapy and treatment completion rates in the years before and after infusion of federal funding for tuberculosis (TB) control in 1993.
		An ecological study of estimated directly observed therapy rates and 12-month treatment completion rates from 1990 through 1994 was undertaken for TB control programs in all 25 cities and counties across the nation with 100 or more incident TB cases in any year from 1990 to 1993.
		Directly observed therapy has had a marked impact on treatment completion rates in jurisdictions with historically low rates.
	www.apha.org /journal/abstracts/ab6july.htm (228 words)

	Directly observed therapy for treating tuberculosis (Cochrane Review) (Site not responding. Last check: 2007-09-08)
		To compare directly observed therapy (DOT) with self administration of treatment in people requiring treatment for clinically active tuberculosis or prevention of active disease.
		There was no statistically significant difference between DOT and self administration of treatment for the number of people cured (RR 1.02, 95% CI 0.86 to 1.21, random-effects model; 1603 participants, 4 trials) or who were cured or completed treatment (RR 1.06, 95% CI 1.00 to 1.13; 1603 participants, 4 trials).
		Stratifying the location of the DOT by home or at a clinic suggests a possible small effect with home-based DOT (RR 1.10, 95% CI 1.02 to 1.18; 1365 participants, 3 trials).
	www.update-software.com /abstracts/ab003343.htm (629 words)

	Directly Observed Antiretroviral Therapy for Injection Drug Users With HIV Infection
		A prospective observational study was conducted to determine the efficacy of directly observed antiretroviral therapy provided in conjunction with daily observed methadone maintenance therapy.
		DOT should therefore be considered a potential option for providing HAART to IDUs, particularly when used in conjunction with methadone maintenance therapy.
		IDUs receiving stable methadone maintenance therapy are required to attend their drug treatment clinic (DTC) on a regular basis for directly observed methadone treatment.
	www.impactaids.org.uk /med1.htm (480 words)

	Directly observed treatment - Wikipedia, the free encyclopedia
		Directly Observed Treatment (DOT) or Directly Observed Therapy is watching the patient take his/her medication to ensure medications are taken in the right combination and for the correct duration.
		It is used for diseases such as tuberculosis or HIV to assure compliance and avoid drug resistance.
		Please help improve this article by adding it to one or more categories, in addition to a stub category.
	en.wikipedia.org /wiki/Directly_observed_treatment (170 words)

	Directly Observed Therapy
		DOT is defined as "observation of the patient by a health care provider or other responsible person as the patient ingests TB medications."
		The Centers for Disease Control and the American Thoracic Society recommend that DOT be considered for all patients as one method of ensuring adherence to a medication regime.
		DOT includes the use of incentives and enablers to encourage adherence.
	www.dhhs.nh.gov /DHHS/CDCS/LIBRARY/Best+Practice/do-therapy.htm (231 words)

	HIV Report March 2001 - Adherence to Antiretroviral Therapy (Site not responding. Last check: 2007-09-08)
		This suggests that the practical impact of directly observed therapy may not be as profound in treatment experienced patients.
		Directly observed therapy appears to be effective in increasing adherence and sustaining virologic suppression.
		In situations where directly observed therapy is not feasible, the simplest self-administered highly active regimen will result in the most sustained virologic and clinical response.
	www.hopkins-aids.edu /publications/report/mar01_9.html (734 words)

	March Initiative in Haiti
		The concept of Directly Observed Therapy (DOT) was devised as a means of dealing with the challenge of viral resistance.
		Trained DOT workers (“accompagnateurs”) are assigned a specific group of patients – usually four or five - whom they visit individually at least once each day to observe personally the swallowing of the pills.
		On their own, patients do not always take their medicines; this can create problems any time, but is particularly serious in the case of AIDS for which the available drugs are only effective if taken daily (usually twice a day) for the patient’s entire life.
	www.som.tulane.edu /march/therapy.html (261 words)

	Directly Observed Therapy : Bureau of Tuberculosis Control : NYC DOHMH
		DOT means that a health care worker meets with a person who has TB to help him or her remember to take the medicines to treat TB.
		Your DOT worker may also be able to help if you have other problems that interfere with your TB treatment.
		All you have to do is talk to your DOT worker, and he or she will take it from there.
	www.nyc.gov /html/doh/html/tb/tbdot.shtml (361 words)

	Directly Observed Therapy for Tuberculosis
		In a letter to the editor, Suzanne Marks and colleagues state that Heymann's decision analysis of directly observed tuberculosis therapy led to erroneous conclusions.
		Furthermore, the authors contend that directly observed treatment does not often use confinement to motivate patients to comply; rather, they point out that incentives and enablers are more commonly used.
		In response, Heymann, of the Harvard School of Public Health, and others note that directly observed therapy is not necessary for TB-incidence reduction, as evidenced by the decline in U.S. TB cases between 1953 and 1985, when the practice was not used.
	www.aegis.com /news/ads/1999/ad990534.html (577 words)

	Aidsmap \| Directly observed therapy shown to be of value for some patients
		Adherence to tuberculosis therapy has been successfully improved in many settings by the use of directly observed therapy.
		Of the patients who remained on the study, 100% after three months, and 90% after six months said that the directly observed therapy had helped them to take their medication.
		In addition, the directly observed therapy was not regarded as an invasion of privacy by 81% of patients at month three and 94% at month six.
	www.nam.org.uk /en/news/D87894CB-2B4E-4705-80FE-54A8B9602DFB.asp (984 words)

	UCSF HIV experts question observed therapy in poor nations
		The editorial notes that DOT for tuberculosis therapy became a public health imperative to prevent emergence of drug resistance strains of TB and that the possibility of creating drug resistant strains of HIV is cited as a rationale for DOT for HIV.
		The possibility that DOT could reduce virus levels in infected individuals and thus make them less able to transmit HIV is also addressed by the editorial.
		The authors observe that there is no evidence yet that DOT is superior to self-administered therapy for reducing transmission through treatment, and if it were proved to be so, that the discussion of HIV DOT should not be limited to resource poor countries.
	www.eurekalert.org /pub_releases/2003-05/uoc--uhe052003.php (503 words)

	Tbmedicaid (Site not responding. Last check: 2007-09-08)
		Directly Observed Therapy, where a health care worker or some other responsible person watches the patient take medication, ensures that patients complete the entire multiple-month course of TB treatment and has been shown improve treatment compliance and reduce TB transmission, as well as prevent the development of costly drug-resistant TB.
		DOT is recommended as the standard of care for all patients with TB by the Centers for Disease Control and Prevention as well as the World Health Organization.
		Although DOT has been the standard of care in Georgia since 1995, existing resources cannot support the full expansion of DOT to all TB patients in Georgia.
	medicine.emory.edu /id/ATPC/medicaid.html (589 words)

	Communities May Be At Risk If TB Patients Don't Undergo Directly Observed Therapy (Site not responding. Last check: 2007-09-08)
		The study provided the first contemporary evidence from a controlled, comparative study that directly observed therapy for TB is clinically, programmatically and statistically superior to self-administered therapy.
		"Directly observed therapy for TB is believed to reduce the prevalence of multi-drug-resistant disease, to cut the cost per case of individuals treated, and to improve the rate of treatment completion," Dr. Davidson said.
		Although patients on directly observed therapy were more likely to complete treatment than those who were self-treating, only 52 DOT patients had completed treatment by eight months which Dr. Davidson described as disappointing.
	www.docguide.com /dg.nsf/PrintPrint/1FE9651499D25AD0852566BF006C12CC (361 words)

	Directly Observed Therapy (D.O.T.)
		The Harlem Directly Observed Therapy (DOT) program, where patients are supervised while medication is administered, has been effective in controlling the spread of TB.
		DOT is convenient and easy to arrange, and it can fit into your daily routine.
		DOT can be made to fit your daily routine.
	www.harlemtbcenter.org /dot_program.htm (391 words)

	What is DOTS Therapy?
		DOTS therapy uses a battery of drugs in a prescribed order to eradicate tuberculosis and avoid the creation of drug-resistant strains of the disease.
		DOTS therapy is designed to be cost-effective, in recognition of limited public health budgets around the world.
		DOTS therapy has five elements, beginning with political commitment which must be accompanied by sustained, increased financial dedication.
	www.wisegeek.com /what-is-dots-therapy.htm (424 words)

	Tips from Other Journals - June 15, 2002 - American Family Physician
		Usually therapy is administered daily during the first two months and twice weekly during the remaining treatment course.
		Al-Dossary and associates conducted an observational trial to determine the effectiveness of a six-month, directly observed therapy (DOT) regimen in children with tuberculosis.
		DOT is a highly effective and relatively inexpensive way to ensure that a child is adequately treated.
	www.aafp.org /afp/20020615/tips/8.html (602 words)

	How Much Directly Observed Therapy Is Enough? American Journal of Respiratory and Critical Care Medicine - Find Articles
		The nation embarked on a major rebuilding of the public health infrastructure for tuberculosis that included a dramatic expansion in the use of directly observed therapy (DOT), a form of tuberculosis treatment in which the ingestion of medications is observed by a healthcare worker.
		The expansion in the use of DOT in the United States was followed by dramatic decreases in multidrug-resistant tuberculosis and the return of overall trends in case rates to the steady decline of previous decades.
		Finally, enhanced DOT is not a standard approach that can be easily tested in a randomized trial, because there are likely to be differences in the ability to institute timely interventions to maintain adherence.
	www.findarticles.com /p/articles/mi_qa4085/is_200409/ai_n9457992 (955 words)

	Directly Observed Therapy (DOT) Assessment Tool - Minnesota Dept. of Health
		Directly Observed Therapy (DOT) is a very effective way to ensure that patients complete adequate tuberculosis (TB) therapy in a timely manner.
		Studies show that TB treatment completion rates are 86-90% for patients receiving DOT, compared to 61% for those on self-administered therapy. All persons starting treatment for suspected or confirmed active TB should be evaluated for their risk of non-adherence to therapy** at the time treatment is initiated.
		DOT referrals should be made to the local health department in the county where the individual resides.
	www.health.state.mn.us /divs/idepc/diseases/tb/dottool.html (476 words)

	AEGiS-08CROI: Impact of directly observed therapy on long-term outcomes in HIV clinical trials.
		AEGiS-08CROI: Impact of directly observed therapy on long-term outcomes in HIV clinical trials.
		Impact of directly observed therapy on long-term outcomes in HIV clinical trials.
		Subjects received study meds as DOT in the DOC and as self-administered therapy (SAT) in the ACRU.
	www.aegis.com /conferences/croi/2001/528.html (364 words)

	APHA - Journal and Newspaper - American Journal of Public Health - Editorials July 1998 - Nihilism and Pragmatism in ... (Site not responding. Last check: 2007-09-08)
		In areas where therapy completion rates were already high, the impact of directly observed therapy was less impressive.
		But directly observed therapy undermines public health nihilism wherever it improves TB outcomes through what is, after all, a modest and focused public health intervention.
		Close scrutiny of settings in which directly observed therapy is held to be key to reversing unwelcome trends in TB control reveals it to have been merely one component of improved services.
	www.apha.org /Journal/editorials/ed3july.htm (1412 words)

	Directly Observed Therapy Does Not Help Fight Tuberculosis
		Directly observed therapy (DOT) has no quantitatively important effect on cure rates or treatment completion in people receiving treatment for tuberculosis (TB).
		One approach to improving compliance has been to directly observe people as they swallow the tablets.
		"DOT is a controversial and expensive intervention, and there appears to be no sound reason to advocate its routine use until we understand the situation in which it may be beneficial," says lead Author Professor Jimmy Volmink, Deputy Dean of Research, Faculty of Health Sciences, Stellenbosch University, South Africa
	www.medicalnewstoday.com /medicalnews.php?newsid=41856&nfid=rssfeeds (384 words)

	Communicable Diseases: Tuberculosis (TB) About Directly Observed Therapy (DOT) - Peel Public Health
		DOT means a DOT Worker from Peel Health will meet with you twice a week.
		With DOT you may only need to take your antibiotics two times a week instead of every day.
		DOT will give you and your family the opportunity to ask questions.
	www.region.peel.on.ca /health/tb/faq-dot.htm (336 words)

	MEDLINE_1996-2006 - Resultado de la búsqueda <página 1>
		Directly observed therapy and treatment completion for tuberculosis in the United States: is universal supervised therapy necessary?
		OBJECTIVES: This study examined the relationship between directly observed therapy and treatment completion rates in the years before and after infusion of federal funding for tuberculosis (TB) control in 1993.
		METHODS: An ecological study of estimated directly observed therapy rates and 12-month treatment completion rates from 1990 through 1994 was undertaken for TB control programs in all 25 cities and counties across the nation with 100 or more incident TB cases in any year from 1990 to 1993.
	www.bireme.br /cgi-bin/wxislind.exe/iah/online/?IsisScript=iah/iah.xis&nextAction=lnk&base=MEDLINE_1996-2006&exprSearch=9663153&indexSearch=UI&lang=e (266 words)

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