2001 International Conference of the American Thoracic Society,
San Francisco, CA. May 2001.
Bower BL, El-Sadr W, Colson PW.
Developing pocket reference guides to reflect new guidelines
for managing Latent Tuberculosis Infection (CDC poster session).
10-15 million people in the US have latent TB infection (LTBI),
and about 10% of them will develop TB disease. Identifying
those with LTBI and ensuring completion of treatment are national
TB control priorities. Appropriate implementation of new CDC/ATS
guidelines is essential. A suitable format for specific provider
groups is needed.
Four key decisions emerged among tasks that clinicians undertake
in managing LTBI: 1) who to test, 2) who to treat, 3) which
treatment regimen to use, and 4) how to monitor treatment
until completion. Key information from guidelines was distilled
in a simple, user-friendly form. Expert review of content
and presentation was obtained. A plan for dissemination and
evaluation was developed and implemented.
Three pocket reference cards were designed for identifying
and treating LTBI among adults, women during pregnancy/postpartum
period, and children/adolescents. Pre-tests identified physicians'
preference for an action-oriented, durable, pocket-sized card,
and these were modified accordingly. To date, 50,000 cards
have been distributed. Early evaluation results indicate a
positive response. 88% agree that the cards address a key
TB control issue, 92% agree all essential information is included,
and format and presentation are easy to use.
The three pocket reference cards demonstrate how detailed
guidelines can be condensed into an easy-to-use and practical
format. By providing information needed at key decision-making
steps, these cards are useful and effective tools. Developing
specific tools that are appropriate for broad clinician types
is necessary to expand partnership in TB control efforts.