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This article examines a change in TB treatment support that occurred in 2005 in South Africa, from DOT to the enhanced TB adherence programme (ETA).
ART: antiretroviral treatment; DOT: Directly Observed Therapy; ETA: Enhanced Tuberculosis Treatment Adherence Programme; HIV: Human Immunodeficiency Virus; NPM: Normalization Process Model; SA: Salla Atkins; TB: Tuberculosis The authors declare that they have no competing interests.
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" the community members and the patients have an opportunity to be part of the support groups we have in the clinic for them to talk about their conditions and link with other patients with similar conditions to form adherence programmes".
Seven studies related their results to potential benefits for individual patients, for instance to tailor adherence programmes, 34 to be helpful in medical decision-making 35 or to promote concordance between patients and psychiatrists.
Physiotherapists will also be audited in their facilitation of the SEPRP programmes in weeks 4 or 5 to ensure adherence to programme principles and content.
Practice nurses will be audited when delivering the SEPRP programmes in weeks 4 or 5 to ensure adherence to programme principles and content.
An action plan will be implemented if there are any concerns regarding adherence to programme content and principles.
Any problems with adherence or programme delivery will be discussed at fortnightly meetings between the trained nurses and study manager.
Barriers to engagement and adherence with programmes included: men not problematising their weight until labelled 'obese'; a lack of support for new food choices by friends and family, and reluctance to undertake extreme dieting.
The 2-year duration of the trial will allow the evaluation of long-term adherence to the programme and predictors of adherence to the programme.
Understanding issues that affect patient adherence to treatment programme is an important component in implementation of a successful TB control programme.
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