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Substance Abuse and Mental Health Services Administration
A Randomized Controlled Trial of Two Treatment Programs for Homeless Adults With Latent Tuberculosis Infection
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Few studies have examined strategies for optimizing adherence to latent tuberculosis infection (LTBI) treatment programs in homeless populations. This study compares the effectiveness of an intervention program employing nurse case management and incentives (NCMI) with a standard care control program with The study also examines the impact of the two programs on tuberculosis (TB) knowledge among participants. Using intent-to-treat analysis, 62% of participants in the intervention program, compared with 39% of controls, completed the full 6-month course of LTBI treatment with INH. Logistic regression modeling revealed that intervention participants had three times greater odds of completing INH treatment than controls. TB knowledge improved in both programs, but the increase was greater among the intervention participants (P < 0.001). The authors conclude that nurse case management combined with education, incentives, and tracking dramatically improves both adherence to LTBI treatment and TB knowledge in homeless persons compared to a standard approach of outreach and incentives. (Authors)