Dot
Dot
Dot
For complex regimens including IV/IM medications or twice daily dosing, home care agencies may provide DOT or share responsibilities with the local health department. If resources for providing DOT are limited, priority should be given to patients most at risk. See the MDH DOT Risk Assessment form for help identifying high-priority patients (www.health.state.mn.us/divs/idepc/diseases/tb/ dottool.html).
How is DOT administered? DOT includes: delivering the prescribed medication checking for side effects watching the patient swallow the medication documenting the visit answering questions notifying the physician if the patient has side effects, clinical problems or misses DOT visits. DOT should be initiated when TB treatment starts. Do not allow the patient to try selfadministering medications and missing doses before providing DOT. If the patient views DOT as a punitive measure, there is less chance of successfully completing therapy. The prescribing physician should show support for DOT by explaining to the patient that DOT is widely used and very effective. The DOT provider should reinforce this message. DOT works best when used with a patientcentered case management approach, including such things as: helping patients keep medical appointments providing ongoing patient education offering incentives and/or enablers connecting patients with social services or transportation Patients taking daily therapy can usually selfadminister their weekend doses.
Page 1 of 2
MDH (1/06)
Page 2 of 2