If a patient will be travelling or absent for longer than two weeks, identify a health facility in the area where the patient's treatment can be followed.

During their regular treatment visits, ask patients to inform you if they have plans to travel, so that arrangements can be made to continue treatment without interruption. If a patient is to travel out of the area, or will be unable to have directly observed treatment for one or more days, provide instructions and drugs for a short period of self-administration; if necessary, you may provide drugs for up to two weeks.

If the patient's drugs are not pre-packaged, prepare a separate packet of drugs for each day that the patient will be absent (Figure 15.2). Give the patient careful instructions, in your conversation with him/her and in writing, about how to take the drugs. Point out the number and colour of the drugs in each day's packet and tell the patient to take the drugs at the same time each day, take the pills with water and take all of the drugs for the day together.

Figure 15.2 Anti-TB drugs are being sorted into separate packages for a patient who is about to travel to another district (Photo: courtesy of the World Lung Foundation/Gary Hampton).

Ask questions such as 'how do you take the medication?' and 'do you divide the dose?' to make sure that the patient understands when and how to take the drugs. On the patient's registration, record the days when you observed treatment and then draw a line through the days on which the patient will take self-administered drugs.

Last modified: Friday, 6 June 2014, 4:50 PM