Background: There is debate over the efficacy of directly observed therapy (DOT) for tuberculosis medication. The purpose of this comprehensive review was to synthesise data from studies comparing DOT and self-administered therapy (SAT) or various kinds of DOT for anti-tuberculosis medication.
Two independent evaluators examined multiple databases for pertinent randomised controlled trials (RCTs) and non-randomised studies. Two reviewers separately evaluated the risk of bias, and papers with a high risk of bias were excluded. One evaluator extracted the data, which was then double-checked by another. Cure and treatment effectiveness were the primary outcome metrics.
We included eight RCTs and 15 non-randomised studies, the majority of which were performed in low- and middle-income nations. There was no compelling proof that clinic DOT was superior than SAT.Both RCTs and non-randomised trials found that community DOT was more successful than SAT. Neighborhood DOT was as good as, if not better than, clinic DOT. The findings showed no statistically meaningful difference between family and non-family community DOT.
Conclusions: If community DOT by non-family members is more practical for patients and less expensive for health services than clinic DOT, it may be the best choice.