1 session 5: working with patients with special challenges

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SESSION 5:SESSION 5:Working with Patients with Working with Patients with Special ChallengesSpecial Challenges

DOT Curriculum Session 5 2

Adherence BarriersAdherence Barriers

1.1. Competing priorities Competing priorities

2.2. Lack of access to health careLack of access to health care

3.3. Being drunk or high Being drunk or high

4.4. Lack of stability; chaotic life Lack of stability; chaotic life circumstances circumstances

5.5. Distrust of authoritiesDistrust of authorities


Adherence BarriersAdherence Barriers (2)(2)

6.6. DenialDenial

7.7. Blaming others for problemsBlaming others for problems

8.8. Depression; feeling overwhelmed by Depression; feeling overwhelmed by one’s circumstancesone’s circumstances

9.9. Additional side effects of TB Additional side effects of TB medications when taken with alcohol medications when taken with alcohol or other substancesor other substances


Adherence BarriersAdherence Barriers (3)(3)

10.10. Others?Others?

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A Working Definition of AddictionA Working Definition of Addiction

Addiction is characterized by:Addiction is characterized by:

• A strong urge to use mood-altering A strong urge to use mood-altering drugsdrugs

• Loss of control over use of these drugsLoss of control over use of these drugs

• Continued use despite negative Continued use despite negative consequencesconsequences

• Possible genetic disposition Possible genetic disposition


A Working Definition of Addiction A Working Definition of Addiction (2)(2)

Addiction is characterized by (continued):Addiction is characterized by (continued):

• Family and social problems due to useFamily and social problems due to use

• Past attempts to stop or control usePast attempts to stop or control use

• Possibility of relapse after the addict Possibility of relapse after the addict stopsstops


Review Questions Review Questions

1. What are three special adherence 1. What are three special adherence barriers faced by TB patients who barriers faced by TB patients who are homeless or use substances? are homeless or use substances?

2.2. What are two different community What are two different community perceptions about why people are perceptions about why people are homeless? homeless?


Review Questions Review Questions (2)(2)

3. What are two different community 3. What are two different community perceptions about why people use perceptions about why people use substances?substances?

4.4. What are three ways to help patients What are three ways to help patients who are homeless or use who are homeless or use substances to complete their substances to complete their treatment? treatment?


Review Questions Review Questions (3)(3)

5. List at least two community 5. List at least two community resources in your area that can help resources in your area that can help patients who are homeless or use patients who are homeless or use substances to address their non-TB-substances to address their non-TB-related challenges.related challenges.

1 session 5: working with patients with special challenges

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