8 INTERNATIONAL RESEARCH & OPINION

TB treabnent completion rates poor in Canada

Careful surveillance of treatment completion is necessary 'to optimize management ofTB [tuberculosis] control programs and to prevent the emergence of multidrug-resistant TB as an important public health problem in Canada', say researchers in that country.

58% is not enough Their retrospective study at 5 university-affiliated

tertiary-care centres in Toronto showed that only 84 of 145 patients (58%) with pulmonary TB were known to have completed treatment. The rate of treatment noncompletion was particularly high among patients with HIV infection (6 of 22; 27%). Further analysis of data showed that patients with mv infection, injection-drug users and those with adverse drug reactions are more likely not to complete treatment.

These patients should be considered 'high priority for directly observed therapy' , note the researchers. Direct observation therapy, as recommended by the World Health Organization, has been shown to be the best way to ensure compliance with prescribed regimens. * The researchers suggest that resources need be provided to ensure adequate follow-up and treatment completion in all patients with active TB. * see also PharmacoEconomics and Outcomes News 207: 11, 10 Apr 1999; 800751938

Wobeser W, Yuan L, Naus M, Tuberculosis Treaunent Completion Study Group. Outcome of pulmonary tuberculosis treaunent in the tertiary care setting - Toronto 1992193. Canadian Medical Association lournall60: 789-794,23 Mar 1999 8"'''''86,

PhannacoEconomics & Outcomes News 17 Apr 1999 No. 208 1173-5503199/0208-00081$01.00° Adis International Limited 1999. All rights reserved