Организация здравоохранения
ORGANIZATION OF OUTPATIENT TREATMENT OF PATIENTS WITH TUBERCULOSIS
G. S. Balasanyants1, I. A. Bozhkov2,3, Y. N. Shitov1
1. Military Medical Academy named after S.M. Kirovof the Ministry of Defense of the Russian Federation, Saint-Petersburg
2. North-West Medical University named after I.I. Mechnikov of the Ministry of Health of the Russian Federation, Saint-Petersburg
3. First St. Petersburg State Medical University named after I.P. Pavlov of the Ministry of Health of the Russian Federation, Saint-Petersburg
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Summary:
Introduction. Ambulatory treatment of TB patients is becomes a priority organizational form of the treatment. Ambulatory treatment of TB patients carried out by three versions - at day-hospital, at “hospital at home” and actually outpatient treatment.
Purpose: to designate the main organizational directions of modern ambulatoryt treatment of patients with tuberculosis.
Materials and methods. Study of legislative and regulatory documents, WHO recommendations, websites of medical journals for key queries reflecting the research topic.
Results and discussion. Ambulatory treatment of TB patients realize according to regimens and anti-TB drugs that described in clinical guidelines. It has undoubted advantages such as: accurate adherence to the treatment principles, patient-centered approach to the provision of anti-TB care, the formation and support of treatment complacence and reduce stigmatization, cost-effectiveness by maintaining significant material resources of the TB service without losing its quality.
In the day-hospital as the part of TB dispensary patient can received full course of chemotherapy in condition of the absence of Mycobacteria tuberculosis excretion. Patients with bacterial excretion can undergo therapy in day-hospital in the continuation phase of the treatment course. The advantage of day-hospital is the possibility of simultaneous pathogenetic therapy. Treatment by “hospital at home” by specially mobile brigade originally offered for people with limited mobility and mainly socially maladjusted patients who categorically refuse to visit an anti-tuberculosis organization are currently receiving elderly patients. This treatment option used at exceptional cases because has limitations such as the absence of a daily doctoral examination that creates the possibility of skipping the initial stage of tuberculosis progression or the development of adverse reactions. Direct outpatient treatment prescribed by district TB doctors within the framework of intra-dispensary work to patients in the continuation phase regardless of the chemotherapy regimen and compliance with the principles of continuity and succession and the formation of adherence to treatment. The modern transformation to video-observed treatment when the patient receive anti-tuberculosis drugs under the supervision of medical personnel by various telecommunication options without visiting the dispensary is very perspective.
Conclusion. Ambulatory treatment of TB patients is an important part of anti-TB care and allows realizing all modern requirements for the treatment and management of TB patients.
Keywords tuberculosis, ambulatory treatment, day- hospital, “home hospital”, video-controlled treatment, patient-centered approach, complacence to treatment, cost-effectiveness
Bibliographic reference:
G. S. Balasanyants, I. A. Bozhkov, Y. N. Shitov, ORGANIZATION OF OUTPATIENT TREATMENT OF PATIENTS WITH TUBERCULOSIS // Scientific journal «Current problems of health care and medical statistics». - 2023. - №2;
URL: http://healthproblem.ru/magazines?textEn=1042 (date of access: 26.12.2024).
URL: http://healthproblem.ru/magazines?textEn=1042 (date of access: 26.12.2024).
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