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Education Materials > Publications > Improving Patients Adherence to TB Treatment > Quick Reference

Improving Patient Adherence to Tuberculosis Treatment (1994)

A Quick Reference to Strategies for Improving Adherence

Quality of Interaction with the Patient

  1. Create a partnership.
  2. Ask patients whether or not they take TB drugs; don't assume they do.
  3. Give each patient adequate time at every visit.
  4. Don't intimidate or frighten the patient; be positive.
  5. Get oral and written commitments from the patient.
  6. Treat the person, not just the disease.
  7. Understand and address different cultural values and beliefs.
  8. Adapt treatment to lifestyle.
  9. Make social service referrals.

Patient Education

  1. Give vital information first in the patient interview.
  2. Be concise and clear with instructions; the patient is likely to be anxious after hearing the diagnosis.
  3. Be clear from the start about the length of the regimen.
  4. Don't overload the patient with too much information at one time; avoid jargon.
  5. Use educational materials that are culturally and linguistically appropriate for the patient.
  6. Be alert for signs or indications that the patient may not be literate.
  7. If using an interpreter, be sure that the interpreter is familiar with the patient's culture.
  8. Assess the patient's beliefs about TB; when possible, integrate beliefs into the treatment plan.
  9. Review instructions; question the patient to ensure understanding.
  10. Describe the specific adherence behaviors required.
  11. Clarify the patient's questions and respond clearly.
  12. Give written instructions.


  1. Schedule the initial appointment soon after diagnosis.
  2. Use appointment reminders.
  3. Follow up quickly on missed appointments.
  4. Tailor the regimen to the patient's needs; allow the patient some options.
  5. Keep the regimen as simple as possible.
  6. Give clear instructions about medication side effects.

Clinic Operations

  1. Ensure a physical environment that is comfortable to patients.
  2. Ensure that all staff are supportive of patients.
  3. Ensure that schedules and practices are tailored to the patients' needs.
  4. Ensure that records management, pharmacy, and lab services are efficient and that they do not inconvenience patients.
  5. Nurture staff morale; provide training as needed.
  6. Provide for confidentiality of patient information.
  7. Provide appropriate clinic services that match the demographic features of the patient population (e.g., temporary housing for homeless patients).
  8. Provide culturally sensitive staff.
  9. Provide interpreters if needed.

Adapted from Sumartojo E, Adherence to the treatment plan: drawing on the research, in: Cohen FL, Durham JD, editors, Tuberculosis: A Sourcebook for Nursing Practice, New York: Springer.


Released October 2008
Centers for Disease Control and Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Division of Tuberculosis Elimination -

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