Key Points of Health Education and Counselling in DR-TB Care

Providing health education and counselling to each Drug-resistant TB (DR-TB) patient is an essential step in the management of DR-TB patients. 

It is important to consider the long duration of treatment and the multitude of factors that may influence the overall treatment continuation and success. 

The treatment duration of any DR-TB regimen is long enough for the patient who needs multiple sessions of counselling, preferably more frequently in the initial phase of treatment. 

Counselling during treatment offers an opportunity to explore and address past and present difficulties faced by patients. The National TB Elimination Programme (NTEP) provides a counsellor at every Nodal DR-TB Centre (NDR-TBC). 

All counsellors and healthcare workers in the health system should know the key points of counselling for DR-TB patients, which include: 

• Confidentiality and informed decision-making process
• Information on the nature and duration of treatment 
• Possible changes in the regimen based on the additional investigations carried out
• Importance of adherence to treatment and the need for complete and regular treatment 
• Consequences of irregular or premature cessation of treatment
• Possible side effects of the drugs
• Mechanism of infection transmission
• Cough etiquette

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The counsellors are expected to maintain the counsellor register for recording the information related to counselling services provided under NTEP.

Resources

• Guidelines for Programmatic Management of Drug-resistant Tuberculosis in India, March 2021.
• WHO Training Modules for the Syndromic Management Sexually Transmitted Diseases, 2nd Edition, Module 5: Educating and Counselling the Patient, 2007.
• Technical and Operational Guidelines for TB in India, 2016.
• Central TB Division, MoHFW, GOI - Training Modules (1-4) for Programme Managers & Medical Officers, NTEP, 2020.

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