Most facilities keep a stock of antiretrovirals on hand in anticipation of this, but the patient must present to medical in order to access the drugs. In order for DOT to be successful, the security and medical staff must value the importance of the dosing schedules. If this is accomplished, sophisticated scheduling can be achieved to accommodate complex dosing regimens. Technically, DOT should include the healthcare provider watching the inmate place the medication in the mouth, watching the inmate swallow the medication and then checking the oral cavity to be sure the inmate has not hidden the medication. Favorable outcome documented Disadvantages of DOT Increased staffing demands Loss of confidentiality Does not teach patient self administration responsibility Distance from cell to med line may prevent patient from making recurrent trips Lack of a once daily regimen that has verified efficacy.
Regimens are usually unrealistic.
Few studies examine adherence to medications within the correctional setting. However the report by Fischl, et al. Although small, this study is the first to be conducted within the correctional setting with comparison to a community-based cohort. The Johns Hopkins University on behalf of its Division of Infectious Diseases and AIDS Service. All rights reserved.