Educational Resources and
Approaches for Managing Complex TB
Cases
Nisha Ahamed, MPH
Rutgers, The State University of New Jersey
Objectives & Outline
At the end of the session,
participants will be able
to:
1. Identify resources for
managing complex TB
cases including MDRTB and co-morbidities
2. Develop approaches
for using available
resources to improve
patient care
• Available resources
• RTMCCs and what
they can offer
– Medical consultation
resources
– Training and education
resources
• Final thoughts
Available resources
• CDC resources
– Multiple educational materials: http://www.cdc.gov/tb/education/default.htm
• Find TB Resources http://www.findtbresources.org
• TB Education and Training Meeting (TB-ETN)
• TBEducate Discussion
http://discussions.cdcnpin.org/connect.ti/tb_educate/groupHome
• RTMCCs
• NTNC: your colleagues!!!
CDC TB Regional Training and Medical
Consultation Centers
Curry International Tuberculosis Center: www.currytbcenter.ucsf.edu
Global Tuberculosis Institute: http://globaltb.njms.rutgers.edu/index.html
Heartland National Tuberculosis Center: www.heartlandntbc.org
Mayo Clinic Center for Tuberculosis: http://centerfortuberculosis.mayo.edu
Southeastern National Tuberculosis Center: http://sntc.medicine.ufl.edu
Medical Consultation
• Offered by all 5 centers – can help in management of complex
cases!
• Health care workers may consult with expert clinicians, nurses
case managers, and others
• Available by phone or email
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Curry International Tuberculosis Center: 877-390-6682
Global Tuberculosis Institute: 800-4TB-DOCS (800-482-3627)
Heartland National Tuberculosis Center: 800-TEX-LUNG (800-839-5864)
Mayo Clinic Center for Tuberculosis: 855-360-1456
Southeastern National Tuberculosis Center: 800- 4TB-INFO
TB Expert Network Webinars
• Offered by CDC and RTMCCs – 6 per year
• Highlight complex cases with input and comment from
multiple experts
• Can be an opportunity to learn more about management of
MDR-TB & other complex cases
• Also, could be an opportunity (in concert with your RTMCC) to
get input on a complex case
RTMCC Educational Resources
Curry International Tuberculosis Center
Drug Resistant TB: Survival guide for Clinicians
3rd Edition to be released December 2014
http://www.currytbcenter.ucsf.edu/products
Curry International Tuberculosis Center
TB Prevention in the HIV-infected Patient: An Online Training
http://www.currytbcenter.ucsf.edu/products
Curry International Tuberculosis Center
TB Drug Information Guide
http://www.currytbcenter.ucsf.edu/products
GTBI Resources
• Outpatient Infusion Therapy for Multi-Drug
Resistant TB: A Practical Guide
– Available online
– Provides rationale for using outpatient infusion therapy
– Describes tasks and processes for provision in clinics
• TB/HIV factsheet
– Available online
– For health care workers
– Review of guidelines with links to additional information
• Tuberculosis Case Management for Nurses: Self
Study Modules
– May be useful review on tasks and procedures for
managing complex cases
GTBI Resources
• Patient Education Flipbook
– Tool for providers to use with patients
– Simple, low-literacy information with appealing images
• Training:
– TB Intensive Workshops
– Provision of tailored offsite training
– Clinical case conference with TB Programs on management of
complex cases
– Archived webinars:
http://globaltb.rutgers.edu/educationalmaterials/audioarchives.htm
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Pitfalls in the Diagnosis and Management of Tuberculosis
Head to Toe: Case Studies in Extra-Pulmonary Tuberculosis
TB Among the Homeless: Dealing with Unique Challenges
Treatment of TB: Managing Adverse Drug Effects
Management of Tuberculosis in the Pregnant Patient
Management of TB Patients on TNF-Alpha Inhibitors
MDR-TB Products
MDR-TB Care Plan
Baseline and monthly Interventions to
monitor an MDR-TB patient for 24
months
English
Spanish
Characteristics of Second-line
Drugs For MTB
Administration of Amikacin
Injection
Mental Health Assessment
Tool
Guidelines for Home &
Hospital Isolation
Other Resources for Managing
Complex TB Cases
Management of the Active TB Patient at Risk of
Hepatotoxicity
Evaluation of Pregnant Patient at Risk for TB
Assessing and Managing the Risk of Liver Disease
in the Treatment of LTBI
Impact of Poor Nutrition on TB Relapse
(English & Spanish)
Rifamycins and Psychotropic Drugs - Drug Drug Interactions
Rifamycins and Anti-Diabetic Agents- Drug-Drug Interactions
Rifamycins and Cardiovascular Agents -Drug-Drug Interactions
Mayo Clinic Center for Tuberculosis
• Monthly Webinars
– First Thursday of every month
• Can provide speakers or planning assistance for
trainings or events within the region
• Trainings:
– TB Clinical Intensive Courses - Fall
– TB Summit, in conjunction with Wisconsin
Department of Health - April 24th
– Mini-TB Clinical Intensive, in conjunction with Mayo
Clinic ID Fellow program - April 26th
SNTC Products
http://sntc.medicine.ufl.edu/products.aspx
Country Guides Currently Available…
Quick Reference Guide – 7 Countries
• Mexico
• Philippines
• India
• Vietnam
• China
• Guatemala
• Haiti
RTMCC All Product Page
• Central Listing
• Search by Words
• Search by RTMCC
http://sntc.medicine.ufl.edu/RTMCCProducts.aspx
Final Thoughts
• Strong case management
• Interdisciplinary approach, considering and addressing
psychosocial factors
• Drug-grams
• Remember, your colleagues are a resource!
Questions and Comments???