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  • 99 DOTS- Envelopes

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    The 99DOTS product consists of customised envelopes (see Figure 1) that fit around the tuberculosis medication blister pack distributed to patients. 

    Figure 1: 99DOTS Envelope

     

    Universal Envelopes (Figure 2): Each adult patient gets the same sleeve, regardless of their weight band.

    These are new envelopes that are currently being introduced by the program. Weight band wise envelopes will be used while the stock lasts, but new requirements by the state will be fulfilled by providing universal envelopes.

    There are 2 types of these envelopes: 1 envelope for IP: Intensive Phase, and 1 envelope for CP: Continuation Phase, for both Macleods and Lupin Fixed-dose Combinations (FDCs). These envelopes are only to be used for adult patients on anti-TB treatment using FDCs.

    Figure 3: Universal 99DOTS Envelopes

    Using the Universal Envelope

    • The counsellor/ pharmacist/ treatment supporter write the number of pills per day the patient should take on the envelope.
    • Every day, the patient will take the prescribed number of pills and reveal 1, 2, or 3 hidden phone numbers. The patient calls any one of the numbers they reveal that day.
    • The patient should start at pill 1 and move in sequence (1,2,3…28), completing each column, and starting from the top of each row.
    • The district should always have sufficient stock, which can be calculated as:
      • Number of IP strips = Number of IP envelopes + some buffer
      • Number of CP strips = Number of CP envelopes + some buffer

    Advantages of the Universal Envelopes

    • There is no need to estimate the requirements of weight band wise envelopes.
    • Less space is required to store the envelopes.
    • Stock-outs of envelopes for a particular weight band will not occur.
    • It is easy for patients to follow the top to down arrow mark pattern while dispensing and ingesting medicines.
    • Counselling time and dispensing time by pharmacists reduce per patient, thus increasing efficiency.

    Resources:

    Assessment

    Question​ Answer 1​ Answer 2​ Answer 3​ Answer 4​ Correct answer​ Correct explanation​ Page id​ Part of Pre-test​ Part of Post-test​
    Which of the following is correct about 99DOTS envelopes? The envelopes have medicine inside them. The envelopes have hidden numbers that can be called by the patient. There are weight-band wise envelopes. All of the above 4 99DOTS envelopes have anti-TB medicines with hidden toll-free numbers that patients call. These envelopes can be weight-band wise or universal envelopes.      
    For weight-band wise 99DOTS envelopes, background colours differ for each weight band. True False     1 For weight-band wise 99DOTS envelopes, background colours differ for each weight band.