Directly observed therapy for treating tuberculosis
Directly observed therapy (DOT) on its own does not offer the solution to poor adherence in people taking TB medication.
Incomplete tuberculosis treatment may result in patients not being cured, and development to drug resistance. Directly Observed Therapy (DOT) is a specific strategy, endorsed by the World Health Organization, to improve adherence by requiring health workers, community volunteers or family members to observe and record patients taking each dose. This review searched for relevant trials up to 13 January 2015, and includes 11 randomized controlled trials that enrolled 5662 people with TB, and were conducted between 1995 and 2008. Overall, cure and treatment completion in both self‐treatment and DOT groups was low, and DOT did not substantially improve this. Small effects were seen in a subgroup of studies where the self‐treatment group were monitored less frequently than the DOT group. The authors conclude that DOT on its own may not offer the solution to poor adherence in people taking TB medication.