NICE tuberculosis guideline addresses adherence
KwangshinN Kim/SPL
Mycobacterium tuberculosis |
Patients' adherence to drug therapy is critical to the success of tuberculosis treatment and an essential element of the National Institute of Health and Clinical Excellence guideline released this week, coinciding with World TB Day on 24 March.
John Hayward, public health adviser and co-chairman of the guideline
development group, speaking at a press briefing, said: “TB is preventable
and curable but it is on the increase in this country. … The NICE
TB guidelines are the gold standard for the prevention, control, diagnosis
and treatment of this ancient but curable disease.”
The guideline emphasises that all patients need to be properly assessed
for barriers to adherence to the full treatment course.
Jane Jones, consultant epidemiologist at the Health Protection Agency,
said that the guidelines offer a patient-centred approach, focusing on
the provision of information and education and the allocation of a “key
worker” for all patients to support them through their treatment. “The
guideline also recognises that it’s crucial to support patients
through what is actually a very prolonged course of treatment,” she
said.
Although the panel emphasised that the key worker will usually be a specialist
nurse, Peter Davis from the British Thoracic Society said that he has
known the TB key worker to be a pharmacist.
Dr Jones said: “The most important aspect of TB control is making
sure people with infectious lung disease are diagnosed promptly and given
effective treatment. This cures the patient, prevents them spreading
it to their close contacts and also prevents the development of drug-resistant
strains.”
The recommended regimen for treatment of standard active TB stated in
the guideline is for six months’ daily dosing of isoniazid and
rifampicin, with pyrazinamide and ethambutol included for the first two
months. Patients receiving directly observed therapy can be offered a
thrice-weekly regimen.
“It’s only by understanding patients’ needs and patients’ difficulties
that we can help support them to complete their treatment, which is not
only good for them, but vital for public health,” Dr Jones emphasised.
The guideline is available from the NICE website |
The
Pharmaceutical Journal
Acrobat
Reader