Administrative monitoring of tuberculosis treatment in Switzerland.
METHODS
Treatment of tuberculosis (TB) is critically dependent on adherence. Directly observed treatment (DOT) has been shown to be effective.


OBJECTIVE
To determine operational treatment outcome using administrative treatment monitoring (ATM) to assess the need for more vigorous promotion of DOT.


METHODS
Cohort study in eastern Switzerland, where ATM was started in 2002. Bi-monthly progress forms and a treatment outcome form (after 6 months) were sent to the treating doctors. Forms not returned within 6 weeks were followed up with phone calls.


RESULTS
Between 2002 and 2004, 98 (87.5%) of 112 new TB patients completed a 6-month treatment course. Eight elderly patients died of causes other than TB while on treatment, four travelled out of the region and two were lost to follow-up. Treating doctors opted for DOT in only seven cases.


CONCLUSIONS
Given the high success rate of 87.5% in our cohort, more vigorous promotion of DOT is not a priority for TB case management in eastern Switzerland. In our setting, ATM in collaboration with the family doctors offers a valuable alternative to the more time-consuming universal DOT.
Guglielmi
S
S
Pulmonary Division, Kantonsspital, St. Gallen, Switzerland.
Barben
J
J
Horn
L
L
Schoch
O D
OD
D000328:Adult; D000369:Aged, 80 and over; D003695:Delivery of Health Care / Q000458:organization & administration*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care / Q000458:organization & administration*; D015995:Prevalence; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013557:Switzerland / Q000453:epidemiology; D014376:Tuberculosis / Q000453:epidemiology / Q000628:therapy*