Have you tried changing up the person that DOT’s the client?  Are you able to DOT in the home?  Does he have a trusted caregiver or family member you could train to administer DOT? 

Sandra Hainline Williams, RN, BSN, MA

Nurse Coordinator for the Marshallese Latino Outreach Team

Dr. Joseph H. Bates Outreach Clinic

Washington County

614 E Emma Ave Suite 247

Springdale, AR 72764

479-751-3630 Office

479-409-9134  cell

479-751-4838 Fax

Sandra.hainline@arkansas.gov

www.facebook.com/jboutreachclinic

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From: TB nurse communication [mailto:nobody@simplelists.com]
Sent: Wednesday, March 13, 2019 7:22 PM
To: tbnurses@ntca.simplelists.com
Subject: Daily digest for tbnurses@ntca.simplelists.com

Non-adherence - Iyer, Patricia (DPH) (13 Mar 2019 13:06 EDT)

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Non-adherence by Iyer, Patricia (DPH) (13 Mar 2019 13:06 EDT)
Reply to list

Good afternoon from Massachusetts,

I was wondering if you might lend your expertise for this very challenging situation. We currently have a case in which the person’s mental illness is so profound that the individual will not take any TB medications, disbelieving the diagnosis. Before the recent decompensation, the individual had about 8 weeks of witnessed therapy, mostly inpatient however has had no TB medications since around Christmas. The individual is currently hospitalized requiring restraint for anti-psychotic injectables but there is no comparable means to do the same with TB medications. I would appreciate any guidance you may provide to work towards a solution and experiences you might have had. We have an inpatient treatment unit which allows compulsory hospitalization however not forced medications.

Thank you for reading,

Pat

Patricia A. Iyer, MSN, RN, BC

Division of Global Populations and Infectious Disease Prevention

Bureau of Infectious Diseases and Laboratory Sciences

MA Department of Public Health

305 South Street

Boston, MA 02130

Telephone 617 983 6971

Fax          617 983 6990

Cell         617 756 3050

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