Online Program

Increasing tx completion of LTBI in high-risk international university students

Sunday, November 3, 2013

Sue Madeja, RN, MSN, Bethlehem Health Bureau, Bethlehem, PA
Amy Anderson, RN, BS-N, Bethlehem Health Bureau, Bethlehem, PA
Medication compliance and regimen completion are common issues for latent tuberculosis (TB) treatment in patients. Latent tuberculosis infection (LTBI), requires 9 months of Isoniazid (INH) and the one most commonly used by local TB clinics for LTBI treatment. New CDC approved treatment regimens are of significantly shorter duration, making treatment initiation more successful and treatment completion more possible. A better solution was needed, and with the 2011 CDC approval of a 12-week INH/rifapentine regimen another treatment option for this group of patients existed that could increase treatment compliance and completion rates.

Conversations were held between the state and local health departments and university staff, a catalyst for discussions about implementation of the new 12- week regimen for university students. Meetings in 2012 with the state department of health, TB program, local health department nursing staff and the university health center began It was decided that the new university students would have two voluntary options: the new CDC approved 12 week regimen and the traditional 9 month regimen resulting in better completion rates. . The new treatment regimen had a slightly more successful completion rate but a higher initiation rate meaning more high-risk students completed treatment. Satisfaction with the new regimen was positive for most students. All students in 2012 chose the new CDC approved 12- week regimen despite the requirement for weekly appointments for directly observed therapy. Completion of LTBI treatment is an important goal for this high-risk population ensuring a reduction in TB disease in these individuals.

Learning Areas:

Clinical medicine applied in public health
Provision of health care to the public
Public health or related nursing

Learning Objectives:
Evaluate use of a new medication regimen for Latent Tuberculosis Infection. Compare completion rates of two different LTBI treatment regimens.

Keyword(s): Tuberculosis, Public Health Nursing

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been in public health nursing for most of my nursing career for a 30 years. I have worked in and supervised nursing staff in the tuberculosis clinic for over 15 years. I have been trained in a variety of tuberculosis roles by experts in the field including State health departments located in New York,New Jersey and Pennsylvania. I am interested in the research surrounding TB and its global affect.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.