***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: This article reports the findings from a clinical study that examined the impact of health education and counseling on the decision of a patient infected with tuberculosis ( TB ) to complete a regimen of isoniazid ( INH ) chemoprophylaxis for 6 months to prevent TB . Forty patients were divided into two groups ; both groups were administered a question naire to collect demographic data and medical history . One group received additional health education and counseling independent of clinic staff , and the other group only received health education and counseling from clinic staff . The proportion of patients in the first group who completed INH for 6 months ( 63.6 % ) was significantly greater than the proportion of patients in the second group ( 11.1 % ) . These findings suggest that health education and counseling did make an impact on the decision of a patient infected with TB to conform with a rational choice when provided with information and a supportive relationship about the consequences of TB infection PURPOSE The purpose of this study was to assess the effect of a clinical pharmacist-directed patient education program on the therapy adherence of first-time tuberculosis ( TB ) patients and to identify the major pharmaceutical care needs and issues of first-time TB and multidrug-resistant (MDR)-TB patients . METHODS In the first part of the study , first-time TB patients were r and omized either to the No EDU group ( n = 58 ) where patients received routine medical and nursing care or to the EDU group ( n = 56 ) where patients were also provided with clinical pharmacist-directed patient education .  The patient 's adherence to treatment was evaluated by attendance at scheduled visits , medication counting , and urine analysis for the presence of isoniazid metabolites . In the second part of the study , the pharmaceutical care needs and issues were determined for first-time TB patients and for MDR-TB patients ( n = 40 ) . RESULTS The adherence of patients who received pharmacist-directed patient education was greater than that of patients who did not . The attendance at scheduled visits and urine analysis for the presence of isoniazid metabolites yielded better results in respect to adherence for the EDU group ( p < 0.05 ) , while medication counting did not differ between the two groups . The major pharmaceutical care needs of first-time TB patients were for pain control , nutrient replacement , appropriate prescribing , respiratory control , and diabetic control . Similar findings were recorded for MDR-TB patients . CONCLUSION Patients ' adherence to TB treatment improved when a pharmacist provided patient education on medication use and addressed patients ' pharmaceutical care issues A 1986 audit of self-administered anti-tuberculous prophylaxis ( SAP ) revealed a compliance rate of 25 % at six weeks , 8 % at 16 weeks , and 5 % at 52 weeks . A short affordable program of daily observed prophylaxis ( DOP ) and education was developed to improve the compliance rate . The sustaining influence of a six week intervention on one year of prophylaxis was determined . Forty-two of 114 ( 37 % ) eligible patients began chemoprophylaxis  and were r and omly assigned to two groups - 21 in Group 1 with DOP and education , and 21 in Group 2 with SAP and education . After six weeks , Group 1 compliance was greater than 1986 compliance ( p less than 0.001 ) and greater than Group 2 compliance ( p less than 0.05 ) , and Group 2 compliance was greater than 1986 compliance ( p less than 0.01 ) . At 16 weeks , 10 weeks after DOP and education were discontinued , the compliance of the three groups was not different . Since 63 % of persons who represent potential future tuberculosis were lost in the evaluation process before starting preventive treatment , and 5 % of those who began preventive treatment completed treatment , only 2 % of potential future tuberculosis was prevented . DOP and education significantly improved compliance but the improvements were not sustained after DOP and education were discontinued Background Information leaflets are widely used to increase awareness and knowledge of disease . Limited research has , to date , been undertaken to evaluate the efficacy of these information re sources . This pilot study sought to determine whether information leaflets developed specifically for staff working with substance mis-users improved knowledge of tuberculosis ( TB ) . Method Staffs working with individuals affected by substance mis-use were recruited between January and May 2008 . All participants were subjectively allocated by their line manager either to receive the TB-specific leaflet or a control leaflet providing information on mental health .  Level of knowledge of TB was assessed using question naires before and after the intervention and data analysed using McNemar 's exact test for matched pairs . Results The control group showed no evidence of a change in knowledge of TB , whereas the TB question naire group demonstrated a significant increase in knowledge including TB being curable ( 81 % correct before to 100 % correct after ) , length of treatment required ( 42 % before to 73 % after ) , need to support direct observation ( 18 % to 62 % ) and persistent fever being a symptom ( 56 % to 87 % ) . Among key workers , who have a central role in implementing a care plan , 88 % reported never receiving any TB awareness-raising intervention prior to this study , despite 11 % of all respondents having TB diagnosed among their clients . Conclusion Further r and omized controlled trials are required to confirm the observed increase in short-term gain in knowledge and to investigate whether knowledge gain leads to change in health status SETTING Tuberculosis Department , Bethania Hospital , Sialkot , Pakistan . OBJECTIVE To determine whether intensive counselling can improve treatment adherence . DESIGN In a r and omised controlled intervention trial of 1,019 adult tuberculosis patients , 49 % were assigned to the intervention group and 51 % to the control group . Baseline data were obtained through semi-structured interviews . Patients were followed until the end of treatment ( cure , default , referral or death ) . The intervention included counselling at the start of treatment and at each subsequent visit for ambulatory patients , or weekly for hospitalised patients . Counselling combined health education with strategies to strengthen patients ' self-efficacy . Control group patients received the usual care . The outcome measure was treatment default . RESULTS The default rate was 54 % in the control group and 47 % in the intervention group : the default risk ratio was 0.87 , implying a reduction in defaulting of 13 % . The impact was stronger in women , ambulatory patients , re-treatment patients , women who worked in the home , and patients who were not the main provider , those with a poor knowledge of the disease or those with a short treatment delay . CONCLUSIONS Intensive counselling has a significant , although limited , impact on treatment adherence Inmates have high rates of latent tuberculosis infection ( LTBI ) , but inmates are often released early and do not complete therapy in the community . This study evaluated the translation of results from a r and omized trial to improve therapy completion to usual care in a county jail using Rogers ' Diffusion of Innovation theory . Inmates who received a single education in the r and omized trial in 1998 - 1999 ( study group ) were compared to inmates educated by Jail Discharge Planners in 2002 - 2003 ( usual care group ) . Outcomes were rates of completion of a visit to the TB clinic and completion of therapy . Subjects in the usual care group were significantly less likely to go to clinic in the 30-day period after release ( relative risk 0.84 , 95 % confidence interval 0.75 - 0.95 ) . The transfer of an educational protocol did not achieve results seen under study conditions , mostly because of implementation fidelity . The educational session in the usual care period for 81.0 % of inmates took 5 min , as compared to 10 - 15 min during the r and omized trial . Differences in personnel administering the protocol , training , high turnover and time available may also account for lower rates seen . Practical clinical trials should focus on the context of care as well as the intervention and should have participation by those who will be implementing results Objective To investigate whether PALSA PLUS , an on-site educational outreach programme of non-didactic , case based , iterative clinical education of staff , led by a trainer , can increase access to and comprehensiveness of care for patients with HIV/AIDS . Design Cluster r and omised trial . Setting Public primary care clinics offering HIV/AIDS care , antiretroviral treatment ( ART ) , tuberculosis care , and ambulatory primary care in Free State province , South Africa . Participants Fifteen clinics all implementing de central isation and task shifting were r and omised . The clinics cared for 400 000 general primary care patients and 10 136 patients in an HIV/AIDS/ART programme . There were 150 nurses . Intervention On-site outreach education in eight clinics ; no such education in seven ( control ) . Main outcome measures Provision of co-trimoxazole prophylaxis among patients referred to the HIV/AIDS/ART programme  , and detection of cases of tuberculosis among those in the programme . Proportion of patients in the programme enrolled through general primary care consultations . Results Patients referred to the HIV/AIDS programme through general primary care at intervention clinics were more likely than those at control clinics to receive co-trimoxazole prophylaxis ( 41 % , ( 2253/5523 ) v 32 % ( 1340/4210 ) ; odds ratio 1.95 , 95 % confidence interval 1.11 to 3.40 ) , and tuberculosis was more likely to be diagnosed among patients with HIV/AIDS/ART ( 7 % ( 417/5793 ) v 6 % ( 245/4343 ) ; 1.25 , 1.01 to 1.55 ) . Enrolment in the HIV/AIDS and ART programme through HIV testing in general primary care was not significantly increased ( 53 % v 50 % ; 1.19 , 0.51 to 2.77 ) . Secondary outcomes were similar , except for weight gain , which was higher in the intervention group ( 2.3 kg v 1.9 kg , P<0.001 ) . Conclusion Though outreach education is an effective and feasible strategy for improving comprehensiveness of care and wellbeing of patients with HIV/AIDS , there is no evidence that it increases access to the ART programme . It is now being widely implemented in South Africa . Trial registration Current Controlled Trials IS RCT N 24820584 SETTING Screening for active tuberculosis ( TB ) and providing isoniazid ( INH ) preventive therapy in jails are important control measures . In San Francisco , however , historical data showed that 62 % of inmates were released before completing preventive therapy , and of those only 3 % attended the TB Clinic for follow-up . OBJECTIVE AND DESIGN A r and omized clinical trial to compare a $ 5 cash incentive plus st and ardized TB education with st and ardized TB education alone in encouraging released inmates to make a first visit to the clinic . RESULTS Of 79 persons enrolled in the trial , 77.2 % were released before INH completion . Rates of first visit were not significantly different for those receiving + 5 plus st and ardized education ( 25.8 % ) versus st and ardized education alone ( 23.3 % ) , but were higher than rates seen in historical data for inmates not receiving st and ardized education . Age was an important predictor of completion of a first visit ( odds ratio 1.09 , 95 % confidence interval 1.02 - 1.16 , P = 0.017 ) . Other variables predicting adherence included intent to adhere , more previous time in jail , stable housing , and being partnered versus alone , although these were not statistically significant . CONCLUSION St and ardized education may be important in improving follow-up after release . Further work on the role of a financial incentive in this population is needed OBJECTIVES We sought to determine the efficacy of coaching Latino adolescents with latent tuberculosis infection to adhere to isoniazid treatment . METHODS Participants ( n = 286 ) were r and omly assigned to adherence coaching , attention control , or usual care groups . Adherence was measured via interviews and vali date d with urine assays . RESULTS Coaching result ed in significant increases in adherence compared with attention and usual care groups . Bicultural adolescents were more likely to be adherent than those most or least acculturated . Age and risk behavior were negatively related to adherence . CONCLUSIONS Coaching can increase Latino adolescents ' adherence to treatment for latent tuberculosis infection and should contribute to tuberculosis control for adolescents at high risk of contracting the disease The design , logic , and results of a two-year health education study directed at i m proving rates of patient adherence to antituberculosis medical regimens are presented . An incentive scheme to reward positive health behaviors plus targeted educational coun seling sessions was implemented in a r and omized clinical controlled trial . The 205 subjects who participated in the study are categorized according to patients with active tuberculosis ( n = 88 ) or preventive patients with no evidence of active disease ( n = 117 ) . Patients in each of these groups were r and omly assigned to a special intervention ( SI ) group or a usual care ( UC ) control group and were followed monthly throughout their treatment program . While SI patients with active tuberculosis demonstrated higher levels of ap pointment-keeping behavior and mean percent of medication taken compared to UC patients , no statistically significant differences between the two groups were found . Pre ventive therapy patients assigned to the SI group , however , were significantly more likely than UC patients to remain in care during their 12-month regimen ( 64 % vs 47 % ; p = 
    Output:
    
Educational or counselling interventions may improve completion of treatment for latent tuberculosis .
As would be expected , the magnitude of the benefit is likely to depend on the nature of the intervention , and the reasons for low completion rates in the specific setting