In countries where legal measures can be taken to force patients to take their medication (e.g., the US), then urine testing can be a useful adjunct in assuring compliance.RMP colours the urine and all bodily secretions (tears, sweat, etc.) an orange-pink colour and this can be a useful proxy if urine testing is not available (although this colour fades approximately six to eight hours after each dose).In study on cases of extra-pulmonary TB (EPTB), researchers at the University of the Philippines Manila found that similarity of symptoms of EPTB to other diseases results to delayed identification  of the disease and late provision of medication. This, ultimately contribute to increasing rates of mortality and incidence rates of EPTB.The World Health Organization (WHO) recommends prescription of fixed-dose combination drugs, to improve adherence to treatment by reducing the number of tablets that need to be taken by people, and also possibly reducing prescribing errors. A Cochrane review, published in 2016, found moderate quality evidence that "there is probably little or no difference in fixed-dose combination drugs compared to single-drug formulations". Treatment adherence strategies
As stated above, non-compliance to anti-tuberculin treatment can result in treatment failure or development of drug-resistant tuberculosis. Therefore, overall treatment strategies should be focused on promoting adherence. WHO and the Centers for Disease Control and Prevention (CDC) recommend a multi-faceted patient centered care approach.
If it can be shown that they are fully compliant with their medication, then the probability that they have another diagnosis (perhaps in addition to the diagnosis of TB) is very high. These patients should have their diagnosis carefully reviewed and specimens obtained for TB culture and sensitivity testing. Patients who get better and then get worse again should likewise be questioned very closely about adherence to treatment. If adherence is confirmed then they should be investigated for resistant TB (including MDR-TB), even if a specimen has already been obtained for microbiology before commencing treatment. Prescription or dispensing errors will account for a proportion of patients who fail to respond to treatment. Immune defects are a rare cause of non-response. In a tiny proportion of patients, treatment failure is a reflection of extreme biological variation and no cause is found. Treatment relapse
Patients are said to relapse if they improve while on treatment, but become ill again after stopping treatment. Patients who experience only a transient improvement while on treatment, or who never respond to treatment are said to have failed treatment and are discussed above. There is a small relapse rate associated with all treatment regimens, even if the treatment has been taken religiously with 100% compliance (the standard regimen 2HREZ/4HR has a relapse rate of 2 to 3% under trial conditions). The majority of relapses occur within 6 months of finishing treatment. Patients who are more likely to relapse are those who took their medication in an unreliable and irregular fashion.