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Patient support interventions to improve adherence to drug-resistant tuberculosis treatment: A counselling toolkit

Erika Kirsten Mohr, Jennifer Hughes, Leigh Snyman, Busisiwe Beko, Xoliswa Harmans, Judy Caldwell, Helene Duvivier, Lynne Wilkinson, Vivian Cox

Abstract


In response to the growing burden of drug-resistant tuberculosis (DR-TB) in South Africa (SA), Médecins Sans Frontières (MSF), with local government health departments, piloted a decentralised model of DR-TB care in Khayelitsha, Western Cape Province, in 2007. The model takes a patient-centred approach to DR-TB treatment that is integrated into existing TB and HIV primary care programmes. One essential component of the model is individual and family counselling to support adherence to and completion of treatment. The structured and standardised adherence support sessions have been compiled into a DR-TB counselling toolkit. This is a comprehensive guide that focuses on DR-TB treatment literacy, adherence strategies to encourage retention in care, and provision of support throughout the patient’s long treatment journey. Along with other strategies to promote completion of treatment, implementation of a strong patient support component of DR-TB treatment is considered essential to reduce rates of loss from treatment among DR-TB patients. We describe our experience from the implementation of this counselling model in a high DR-TB burden setting in Khayelitsha, Cape Town, SA.


Authors' affiliations

Erika Kirsten Mohr, Médecins Sans Frontières Khayelitsha, Cape Town, South Africa

Jennifer Hughes, Médecins Sans Frontières Khayelitsha, Cape Town, South Africa

Leigh Snyman, Médecins Sans Frontières Khayelitsha, Cape Town, South Africa

Busisiwe Beko, Médecins Sans Frontières Khayelitsha, Cape Town, South Africa

Xoliswa Harmans, Médecins Sans Frontières Khayelitsha, Cape Town, South Africa

Judy Caldwell, Department of Health, City of Cape Town, South Africa

Helene Duvivier, Médecins Sans Frontières South Africa and Lesotho

Lynne Wilkinson, Médecins Sans Frontières Khayelitsha, Cape Town, South Africa

Vivian Cox, Médecins Sans Frontières Khayelitsha, Cape Town, South Africa

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Keywords

Drug-resistant tuberculosis; Loss from treatment; Counselling; Patient support

Cite this article

South African Medical Journal 2015;105(8):631-634. DOI:10.7196/SAMJnew.7803

Article History

Date submitted: 2015-09-23
Date published: 2015-09-23

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