Queensland Tuberculosis Control Program (QTCP)

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Tuberculosis (TB) treatment programs

The Queensland Tuberculosis Control Program (QTCP) coordinates treatment programs including the home visiting program and directly observed therapy program for all TB patients in Queensland.

TB home visiting program

As part of the QTCP home visiting program, nurses provide free support to public and private patients taking TB chemotherapy. Patients receive medical and nursing assessments and telephone calls for the duration of their treatment.

In south-east Queensland (within approximately a 150km radius of Brisbane), a nurse will visit patients at home at least once a month during treatment.

For patients outside south-east Queensland, home visits are provided through regular regional clinics every few months north to Bundaberg and west to Eidsvold.

During a patient’s treatment, nurses assess:

• the individual’s health status at time of visit
• any side-effects to the drugs
• medication compliance/adherence
• continuity of medication supply
• continuity of regular medical assessments.

In addition, nurses play a patient advocacy role, identify issues that may affect the patient’s progress and educate the patient, carer and family about the treatment as required.

Any variances identified through nursing assessments are reported to the treating doctor for appropriate follow up. The QTBCC nurse ensures clinical instructions are implemented and documents the outcome in the patient’s health record.

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TB directly observed therapy program

Directly observed therapy (supervised treatment) for TB chemotherapy is usually only required if:

• a language barrier exists that prevents a patient’s full understanding of need for adherence to treatment
• the patient has clinical complications
• there are proven or suspected medication compliance issues
• the patient has been previously treated for TB.

Directly observed therapy is not seen as a policing measure, but as a support tool to help achieve an optimal treatment outcome. While the World Health Organization (WHO) recommends directly observed therapy for all patients being treated for TB, in Queensland, only specific patients are placed on directly observed therapy. This is because all Queensland patients taking TB medication are closely monitored under the QTBCC home visiting program.

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Who can supervise TB treatment?

A procedure for supervising TB treatment as part of directly observed therapy has been set by the QTBCP. Supervised treatment can be administered by:

• Queensland Tuberculosis Control Centre (QTBCC) nurses (for patients within a 40km radius of Brisbane) or regional TB control unit nurses (for patients outside this radius)
• domiciliary nurses
• a responsible family member or friend
• local health facility staff and GPs
• other responsible supervisors.

If a person other than QTBCC or regional TB control unit nurse will be providing supervision, the QTBCP provides education and support (with particular focus on risk and infection control) to ensure an optimal outcome. Supervisors need to know QTBCC contact details should they require further information or need to seek emergency medical assistance. Contact us to discuss provision of supervised treatment.
 

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