A comparison study of the Cost effectiveness of FamilyBased DOTS (FB-DOTS) versus Professional-Family Mix DOTS (PFM-DOTS) in treating smear positive tuberculosis in Tabriz, ۲۰۱۱-۲۰۱۲

Abstract

Abstract Introduction: Tuberculosis is a contagious bacterial disease of high burden worldwide which necessitates development of new treatment strategies to bring the disease under control. The present study aimed at comparing the effectiveness of Family-Based DOTS versus Professional-Family Mix DOTS in smear positive tuberculosis patients. Methods and materials: In a semi-experimental study, performed in ۲۰۱۱-۲۰۱۲, ٥۷ tuberculosis patients meeting inclusion criteria were recruited into either FB-DOTS or PFM-DOTS groups. The patients took their medications under supervision of a family member and a health expert in the two methods, respectively. At baseline of the study, knowledge of the patients as well as their supervisors, and at the endpoint, life quality, knowledge and satisfaction of the patients along with the knowledge and satisfaction of their supervisors were assessed. Results: In PFM-DOTS group, ۱۰۰٪ and in FB-DOTS group, ۸٦٫٦٪ of the patients took their medications timely. Percentage difference of sputum smear negative (culture) was ۱٦٫۲ (٤٫۸)% and ۷٫۷ (٦٫۹)% for the PFM-DOTS and FB-DOTS by the end of the second and forth months of treatment, respectively (p (culture)= ۰٫٦۳٤, p (smear)= ۰٫۳٦٦). The results also indicated that both for the patients and the supervisors, there was a significant difference between the two groups in knowledge (p<۰٫۰۰۱), satisfaction (p (patients)= ۰٫۰۰۱, p (supervisors)= ۰٫۰۳۷) and all four aspects of life quality (p (physical health)= ۰٫۰۳٦, p (psychological health)<۰٫۰۰۱, p (social relations)= ۰٫۰۲٦ and p (environmental health)<۰٫۰۰۱) by the end of study course which showed the efficacy of the treatment applied. Conclusion: The PFM-DOTS treatment strategy in which health experts follow the patients in their homes, results in a faster recovery from the ailment and significant increases in patients and supervisors satisfaction, the life quality of patients and knowledge of the patients and their families on the disease, compared to FB-DOTS strategy; thus, it may be among most appropriate strategies in treating tuberculosis.