TB Manual Chapter 9: TB Case Management describes the activities assigned to the local TB Control Unit, specifically the responsibilities of the employee assigned to the case to regularly review patient progress and address any barriers to adherence. This ensures the successful completion of tuberculosis (TB) treatment and the subsequent cure of the patient. It outlines the recommendations and guidance for conducting initial assessments, developing treatment plans for case management activities, including the plan for directly observed therapy (DOT), and conducting monthly ongoing assessments with a physician. Included amongst the monitoring is watching for side effects and adverse reactions to medication while monitoring bacteriologic and clinical improvement as a response to medication. The last of the steps outlined are following treatment completion: verify completion of therapy and evaluate case management activities. For unique situations of non-adherence or push back, the use of incentives and enablers to improve adherence to therapy, and if necessary, when and how to use legal orders for the patient to adhere to therapy are discussed as well.
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