Directly Observed Therapy (DOT): Information for Health Care Providers

DOT helps you take care of your patients.

Studies have shown, the main reason tuberculosis (TB) patients relapse, fail treatment, or become drug resistant is that they don't take their TB medications as prescribed. Most practices don't have the resources to ensure patients complete their treatment – a Directly Observed Therapy (DOT) program can do that. There is no cost to you or your patients. It's self supporting through Medicaid and other reimbursement.

DOT is the standard of care

for all TB patients in New York State. DOT should be provided to every patient with active TB disease. The patient's local health department is responsible for arranging DOT case management services.

DOT acts as an extension of your practice.

DOT gives you an effective tool to ensure patient compliance with their treatment regimen. Patients remain under your care while DOT workers from the local health department (LHD) make sure they take their medications for the full course of their treatment.

TB treatment can be a challenge for anyone. DOT makes medicine-taking simpler. Each patient is assigned a worker for one-to-one care. The DOT worker can even go to a patient's home or worksite to facilitate the process. And, of course, patient confidentiality is maintained.

DOT is good for patients.

Patients who take their medications don't become ill again and don't require expensive re-hospitalization.

How can you get DOT for your patient?

Contact your LHD TB Program as soon as you suspect a patient has tuberculosis. DOT will then be arranged. If the patient is still hospitalized, DOT can be planned before the patient is discharged to ensure continuity of care.

Here's what the TB experts are saying about DOT:

"When only partial DOT takes place, tri-weekly become try weekly, try weekly, becomes try weakly, and weakness leads to failure!"

Dr. Hans Reider, IUATLD International Union Against Tuberculosis and Lung Disease

"Directly observed therapy is the preferred core management strategy for all patients with tuberculosis."

American Thoracic Society/ Centers for Disease Control and Prevention/ Infectious Disease Society of America, Treatment of Tuberculosis, 2003, p. 15

"The most effective way of ensuring that patients are taking their medication is to use directly observed therapy, which involves having a member of the health care team observe the patient take each dose of each drug."

Institute of Medicine, from "Ending Neglect": IOM Committee on the Elimination of Tuberculosis in the United States, p. 17

Help us protect public health.

Work together with your state and local health agencies to make sure that TB patients complete treatment. DOT is an important tool to help stop the spread of TB and drug-resistant TB.