Recommendations for Strategies to Improve Adherence to Treatment for Latent Tuberculosis Infections

While significant progress has been made toward the elimination of tuberculosis in the United States (U.S.), it remains a public health problem in other parts of the world (Centers for Disease Control and Prevention [CDC], 2016a). Completion of Latent Tuberculosis Infection (LTBI) treatment is essential to controlling and eliminating tuberculosis (TB). Treatment completion is determined by the number of doses ingested over a given period of time. Adherence to LTBI treatment is important because it can improve the control of disease transmission and it is a key strategy to reduce TB disease incidence in industrialized countries. A literature review was conducted to assess ways to improve adherence to LTBI treatment and provide recommendations for implementation. The evaluation focused on three main strategies-healthcare provider-centered, clinic-centered, and patient-centered-to find ways to improve adherence to LTBI treatment regimens. Based on the results of the studies evaluated, directly observed therapy (DOT) showed an increase in adherence to LTBI treatment of approximately 70-80% especially when used in conjunction with other patient-centered strategies and innovative treatment regimens. DOT is when qualified healthcare staff observe TB patients taking their TB medication to ensure adherence to treatment; therefore, a recommendation is that DOT along with innovative regimens and patient-centered strategies be implemented to improve adherence.