City tuberculosis control coordinators' perspectives of patient adherence to DOT in São Paulo State, Brazil, 2005.
METHODS
Thirty-six priority cities in São Paulo State, Brazil, with a high incidence of tuberculosis (TB) cases, deaths and treatment default.


OBJECTIVE
To identify the perspectives of city TB control coordinators regarding the most important components of adherence strategies adopted by health care teams to ensure patient adherence in 36 priority cities in the State of São Paulo, Brazil.


METHODS
Qualitative research with semi-structured interviews conducted with the coordinators of the National TB Control Programme involved in the management of TB treatment services in the public sector.


RESULTS
The main issues thought to influence adherence to directly observed treatment (DOT) by coordinators include incentives and benefits delivered to patients, patient-health care worker bonding and comprehensive care, the encouragement given by others to follow treatment (family, neighbours and health professionals), and help provided by health professionals for patients to recover their self-esteem.


CONCLUSIONS
The main aspects mentioned by city TB control coordinators regarding patient adherence to treatment and to DOT in São Paulo are improvements in communications, relationships based on trust, a humane approach and including the patients in the decision-making process concerning their health.
Arcêncio
R A
RA
College of Nursing, University of São Paulo at Ribeirão Preto, São Paulo, Brazil.
Oliveira
M F
MF
Cardozo-Gonzales
R I
RI
Ruffino-Netto
A
A
Pinto
I C
IC
Villa
T C S
TC
D001938:Brazil; D018672:Community Health Planning; D003153:Community Health Services / Q000458:organization & administration*; D023801:Directly Observed Therapy; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010349:Patient Compliance; D011369:Professional-Patient Relations; D012944:Social Support; D014376:Tuberculosis / Q000188:drug therapy*