Improving Patient Adherence to Tuberculosis Treatment
A Quick Reference to Strategies for Improving Adherence
Quality of Interaction with the Patient
- Create a partnership.
- Ask patients whether or not they take TB drugs; don't assume
- Give each patient adequate time at every visit.
- Don't intimidate or frighten the patient; be positive.
- Get oral and written commitments from the patient.
- Treat the person, not just the disease.
- Understand and address different cultural values and beliefs.
- Adapt treatment to lifestyle.
- Make social service referrals.
- Give vital information first in the patient interview.
- Be concise and clear with instructions; the patient is likely
to be anxious after hearing the diagnosis.
- Be clear from the start about the length of the regimen.
- Don't overload the patient with too much information at one
time; avoid jargon.
- Use educational materials that are culturally and linguistically
appropriate for the patient.
- Be alert for signs or indications that the patient may not be
- If using an interpreter, be sure that the interpreter is familiar
with the patient's culture.
- Assess the patient's beliefs about TB; when possible, integrate
beliefs into the treatment plan.
- Review instructions; question the patient to ensure understanding.
- Describe the specific adherence behaviors required.
- Clarify the patient's questions and respond clearly.
- Give written instructions.
- Schedule the initial appointment soon after diagnosis.
- Use appointment reminders.
- Follow up quickly on missed appointments.
- Tailor the regimen to the patient's needs; allow the patient
- Keep the regimen as simple as possible.
- Give clear instructions about medication side effects.
- Ensure a physical environment that is comfortable to patients.
- Ensure that all staff are supportive of patients.
- Ensure that schedules and practices are tailored to the patients'
- Ensure that records management, pharmacy, and lab services are
efficient and that they do not inconvenience patients.
- Nurture staff morale; provide training as needed.
- Provide for confidentiality of patient information.
- Provide appropriate clinic services that match the demographic
features of the patient population (e.g., temporary housing for
- Provide culturally sensitive staff.
- 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 - http://www.cdc.gov/tb
Please send comments/suggestions/requests
CDC/Division of Tuberculosis Elimination
Communications, Education, and Behavioral Studies Branch
1600 Clifton Rd., NE - Mailstop E-10, Atlanta, GA 30333