Case Management
A practice model that uses a systematic approach to identify specific patiente and to manage patient care to ensure optimal outcomes.
Table Preventing patient stopping treatment too early
Checklist of action
1. Be KIND, FRIENDLY and PATIENT.
2. EXPLAIN DISEASE to patient and relatives. In doing this, remember there may be local beliefs about tuberculosis (p 16).
3. EXPLAIN IMPORTANCE OF FULL TREATMENT to patient and relatives.
4. Show him and them the KIND OF PILLS he will take and tell him how to take them.
5. Tell him and his relatives about POSSIBLE REACTIONS to the drugs. Tell him to come and see you if he gets a reaction.
6. Give him a LEAFLET about tuberculosis and its treatment.
7. Tell him and his relatives about your LOCAL ARRANGEMENTS FOR SUPERVISION of treatment. e.g. admission to ward/hostel
or daily attendance at centre near his home for first 2 months
or supervision by volunteer or responsible person in his village.
8. Carefully tell him, and give him a card, the DATE and PLACE of his next attendance. If there is a local calendar, different from the standard international calendar, give him the date in the local calendar. He will understand that better.
9. Check on his/her PERSONAL PROBLEMS, e.g. job, marriage, 'what the neighbours will say'. Give him/her kind and friendly advice about any problem. Because such counselling often takes time, in some clinics it is found best to get a nurse or Health Assistant with a good and friendly personality to do the counselling.
10. When he comes back for a new supply of drugs, remember to check the number of pills left over. This will tell you whether he has taken all the doses. If he has not taken all the doses, ask him in a sympathetic way why he has not. This will help you to give him the right advice about taking his full treatment.
