Alaska Tuberculosis Program Manual - Epidemiology - State of Alaska

Biweekly (BIW) doses of TB medications should be scheduled at least
two (2) and preferably three (3) days apart whenever possible to avoid
long intervals between doses.
How to Deliver Directly Observed Therapy
In Alaska, PHN case managers are responsible for recruiting, training, and
monitoring the work of DOT aides.
The TB/LTBI Prescription and Medication Request Guidelines contain
detailed information on ordering and storing antituberculosis medications.
It is available in the Forms section of the manual 18.1.
Who Can Deliver Directly Observed Therapy?
PHNs or other clinical staff, such as a nurse or other healthcare worker
Staff at other healthcare settings, such as outpatient treatment centers
Other responsible persons, such as school personnel, employers, others trained
by the PHN case manager
DOT Aides in Alaska
Not immediate family members 71
DOT Aides, Regimens, and Payment for DOT Services
DOT Aides
PHN case managers are responsible for organizing and managing DOT. These
responsibilities include identifying, hiring, training, and monitoring the work of DOT
aides. The patient and DOT provider should agree upon the time and place for DOT
encounters. Sites might include a clinic, workplace, public meeting place such as a
restaurant, or the patient’s home. In addition to providing DOT and documenting all
doses according to guidelines, the DOT aide also reports symptoms of adverse
reactions, missed doses, and anticipated patient travel to the PHN case manager. DOT
can be provided by PHN staff, CHA/CHAPs, teachers, workplace safety officers and
other reliable adults. Immediate family members should only be considered as DOT
aides when all other options have been exhausted and must be approved by the Alaska
TB Program.
A L A S K A T B P R O G R A M M A N U A L Case Management 10. 35
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