New responsibilities for health departments and public health nurses in tuberculosis-- keeping the outpatient on therapy.

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Abstract
Outpatient chemotherapy of tuberculosis can be as effective as inpatient therapy. In practice, however, outpatient programs are often inferior because many patients do not take their medication properly. To avoid this, hospitals and clinics must greatly improve their education programs for patients. In order to maintain patient cooperation, health departments need to arrange more convenient personalized clinic services. Losses to supervision must be avoided whenever possible through use of lists of relatives obtained on all patients when they are first hospitalized, careful plans for continued chemotherapy when patients move, and vigorous searches at the first sign that a patient may be lost. Regularity of drug ingestion should be promoted by the choice of medication with the least amount of unpleasant side effects. Consumption of medication should be supervised by maintaining careful records of the amount of medication dispensed and through the use of home visits to check on the amount of medication consumed. Family help should be enlisted whenever possible. Directly administered medication given on an outpatient basis should be used for patients found not to be taking medication.