Table 1 Mapping of the included reviews to the selected cochrane effective practice and organisation of care group organizational interventions a
From: Interventions to improve delivery of isoniazid preventive therapy: an overview of systematic reviews
Intervention | Definition | Example of intervention | Reviews mapped to this category | Bottom-line statements of effectiveness |
|---|---|---|---|---|
Changes to the setting/site of service delivery (3 reviews) | This intervention could include providing IPT outside of the usual TB clinic setting, such as in an HIV care and treatment center for HIV-infected patients or in the household through home-based care programs for TB child contacts or in another community-based setting. | Introduction of IPT to community settings such as methadone clinics or shelters (Al-Darraji et al, 2012 [23] and DeFulio et al, 2012 [24]); integration of TB/HIV services (Uyei et al, 2011 [25]) | Al-Darraji et al, 2012 [23]; DeFulio et al, 2012 [24]; Uyei et al, 2011 [25] | Overall, high levels of adherence and a range of treatment completion of IPT were reported. |
Changes in medical records systems (0 reviews) | This intervention might include changing from paper to computerized records and the use of patient-tracking systems. | None | None | N/A |
Presence and organization of quality monitoring mechanisms (2 reviews) | Quality monitoring mechanisms may include monitoring of medication or treatment outcomes. | Provision of directly observed therapy (DOT) for LTBI (Hirsch-Moverman et al, 2008 [26]; Zuñiga et al, 2012 [27]) | While higher adherence was observed with DOT than self-administered therapy, actual completion rates in comparative studies remain suboptimal—as low as 44% to at best 80% (Hirsch-Moverman et al, 2008 [26]). | |
Revision of professional roles, e.g., nurses and lay health workers (1 review) | This intervention includes shifts in the roles among caregivers, also known as ‘professional substitution’ or shifting boundaries in professional care [28]. | Use of lay health care workers for peer supported self-supervision or DOT | Lewin et al, 2010 [9] | There was moderate quality evidence that this type of support had little or no effect on the completion of IPT. |
Integration of IPT delivery into primary health care services (0 review) | This intervention focuses on improving access by incorporating IPT delivery into other health care services | None | None | N/A |