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Legal intervention for non-adherent patients in the treatment of tuberculosis
E N Pritchett1, D Schlossberg, G Lovett-Glenn
1Philadelphia Department of Public Health, Philadelphia, Pennsylvania 19146, USA. nikki.pritchette@phila.gov
Background:
The Philadelphia Department of Public Health Tuberculosis (TB) Control Program has a progressively severe, stepwise legal process for managing non-adherent TB patients, potentially culminating in incarceration.
Objective:
To review the application of legal procedures and to evaluate their effectiveness in the management of non-adherent TB patients.
Methods:
We evaluated this process by reviewing patients' records from 2001 to 2005 to identify all non-adherent patients and determine their treatment outcomes.
Results:
In this period, we initiated the legal process for 39 non-adherent patients. One patient died, and nine patients were lost. Twenty-nine patients became adherent after the use of a legal intervention. Our final completion percentage was 76.3%.
Conclusion:
Our legal process improved the treatment completion rate for patients who would otherwise have been non-adherent. Increasing treatment completion rates reduce the risk of relapse and disease transmission as well as the growing rate of anti-tuberculosis drug resistance.
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