Implementing a directly observed therapy program in an urban community hospital.
St. Clare's Health and Hospital Center has implemented a directly observed therapy (DOT) program for a challenging urban population of largely HIV+ patients in response to a need for the prevention of the spread of multidrug-resistant tuberculosis in the population. Identified treatment barriers are needs of patient subgroups within the population. Issues in the implementation include: patient compliance, effectiveness of patient identification and follow-up, and continuity of care. Challenges to continuity of care include patients signing out of the hospital against medical advice and missed clinic appointments. Patient identification and follow-up is enhanced by coordinating DOT treatment with the methadone maintenance treatment program.
Sharp
V
V
Spellman Center for HIV-Related Disease, St. Clare's Hospital, New York, New York, USA.
Bray
D
D
Carey
J
J
D017088:AIDS-Related Opportunistic Infections / Q000517:prevention & control; D000328:Adult; D000553:Ambulatory Care / Q000458:organization & administration; D003153:Community Health Services / Q000458:organization & administration*; D003266:Continuity of Patient Care; D005260:Female; D006764:Hospitals, Community; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City; D010349:Patient Compliance; D018088:Tuberculosis, Multidrug-Resistant / Q000517:prevention & control*