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Medical Primer
DOTS Brochure
Published on: March 09, 2010

What is The Medical City DOTS Unit?

The Medical City DOTS Unit is a special diagnostic and therapeutic unit catering to patients diagnosed with or suspected of having tuberculosis.  DOTS is the  acronym for “Directly Observed Therapy Short Course”, the only strategy acknowledged and endorsed by both the World Health Organization and the Department of Health as the best strategy for managing patients with tuberculosis.

A review of The Medical City’s hospital statistics reveal that tuberculosis ranks consistently among  the annual top 20 reasons for admission and consult among both in-patients and out-patients.  Likewise, cases of extra pulmonary forms of tuberculosis, such as TB adenitis, Pott’s disease, genitor-urinary TB (GUTB) and TB meningitis continue to figure prominently in the census of surgical departments. 

For this reason, The Department of Heath and The Medical City, in a strategic partnership, developed The Medical City DOTS Unit, a public-private mix endeavor that aligns the hospital’s adherence to accepted standards of care, and acknowledges the significant contribution of the private health sector in the fight against TB.

What is DOTS?

DOTS is a strategy that standardizes the diagnosis and treatment of tuberculosis.  It operates by the standard protocol of both the World Health Organization and the Department of health in providing the following services:

1.         Supervised collection of sputum specimens in a centralized collection area

2.         Sputum processing by competent microscopist  trained under the DOH

3.         Free anti-TB medicines for the entire duration of treatment for a patient diagnosed with active TB

4.         Daily supervised intake of anti-TB medicines by DOH-trained unit staff

Since the emphasis of the TB program is on patient adherence to treatment, the program encourages patients to take their medicines under the daily directly observation (hence the term “directly observed treatment”) of a treatment partner, preferably a member of the unit staff.  Other treatment partners may be volunteered and trained, such as barangay health workers, the patients’ spouse or other close family members.

observed treatment”) of a treatment partner, preferably a member of the unit staff.  Other treatment partners may be volunteered and trained, such as barangay health workers, the patients’ spouse or other close family members.

How can a Medical City physician and patient have access to the DOTS Unit?

All out-patients with requests for sputum AFB smears shall automatically be directed by the ambulatory clinic staff to the TMC DOTS Unit for their sputum collection.  Sputum specimens shall be collected and processed under the supervision of the DOTS Unit nurse and microscopist, both of whom shall ensure the completion of all three specimens prior to the release of the official results.  In-patients shall have their sputum collection under the supervision of their nurse, and provisional or daily results may be released by the laboratory if requested by the attending physician. 

Patients with sputum positive results shall be directly enrolled into the DOTS program, and shall be eligible to receive free anti-TB medicines for the duration of their treatment regimen.  All enrolled patients are assigned a treatment partner who shall be responsible for directly observing the patient’s intake of medicines. Regular follow-up with the attending physician shall be strongly encouraged.

What if a patient is sputum negative for TB but is still suspected of having the disease based on symptoms and radiographic findings?

The DOH algorithm for these sputum-negative patients with a likelihood of having TB dictates that these cases should be deliberated on by a TB Diagnostic Committee (TBDC).  In The Medical City, the TBDC consists of DOH-trained consultants from the Sections of Pulmonary Medicine and Infectious Diseases and the Department  of Radiology, and is responsible for discussing smear-negative cases in the light of these patients’ history and examination findings.

The attending physician of deliberated cases are encouraged to attend Committee meetings.  Patients who are decided on by the TBDC as having active disease will be enrolled in the DOTS  Program and shall be eligible to receive free medicines.


 


DIRECTLY OBSERVED THERAPY

SHORT COURSE (DOTS) CLINIC

 G/F,  The Medical City

Ortigas Avenue, Pasig City, Metro Manila, Philippines

Schedule: Monday-Sat except Thursday

8 am-12nn and 2pm-5pm

 

CENTER FOR PATIENT PARTNERSHIP

Empowering patients to be our partners in the management of their health

2/F Podium Bldg., Ambulatory Center

Ortigas Avenue, Pasig City, Metro Manila, Philippines

Tel. No. (632) 635-6789 Ext. 6444

Email: mail@medicalcity.com.ph

www.themedicalcity.com


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