Therapeutic patient education and patient support services — MSF Tuberculosis — Médecins Sans Frontières 2026

MSFClinical guideline (chapter)Current edition

From Tuberculosis › Chapter 13: Adherence to tuberculosis treatment · Médecins Sans Frontières, Current online edition, 2026

Guidance on therapeutic patient education, emotional and social support for tuberculosis patients throughout treatment.

In one sentenceTuberculosis patients require ongoing therapeutic education, emotional and social support from multidisciplinary teams throughout treatment, with DR-TB patients needing substantial support given treatment toxicity and duration.

Issuer: Médecins Sans Frontières
Edition: Current online edition, 2026
Audience: Healthcare teams managing tuberculosis patients: clinicians, nurses, treatment supporters, social workers, counsellors
Evidence: Expert consensus
Reviewed: 23 Oct 2026 · GMJ

Read the original on MSF Whole guideline (PDF)

Summary by GMJ Guidelines Desk•Reviewed by Prof. Giorgi Pkhakadze, MD, MPH, PhD•Record updated 23 Oct 2026•Next check Apr 2027

What this guideline says

GMJ summary

This section of the MSF tuberculosis guideline addresses the essential components of therapeutic patient education and patient support services for tuberculosis patients. It emphasises that support requires the involvement of the entire healthcare team, including clinicians, nurses, treatment supporters, social workers and trained counsellors, and should be delivered through various channels including educational sessions, home visits, video and telephone contacts.

The guidance outlines three key pillars: therapeutic patient education (helping patients understand their disease and treatment, enabling self-management skills, and answering questions throughout treatment); emotional support (listening to patients, encouraging honest communication about treatment challenges, and early detection and management of mental health problems such as anxiety and depression); and social support (implementing measures for patients with limited resources, including assistance with disability allowances, housing, food, transportation vouchers or reimbursement). The document emphasises that support is particularly critical for patients on drug-resistant tuberculosis (DR-TB) treatment due to treatment toxicity and duration, and that adherence may vary over time with phases of acceptance and rejection.

Key points

For clinicians — doses and thresholds as stated in the guideline

Therapeutic patient education and support require involvement of the entire healthcare team: clinicians, nurses, treatment supporters, social workers and trained counsellors
Support should be provided throughout treatment via various channels: in-facility educational sessions, home visits, video and telephone contacts
Patients on DR-TB treatment usually require substantial support due to toxicity and long duration of treatment
Therapeutic patient education enables patients to acquire and maintain skills to manage their treatment and disease in everyday life
Healthcare teams should be sensitised to early detection and management of mental health problems (anxiety, depression) that may negatively impact adherence
Social workers can help obtain disability allowances, housing assistance and shelter for homeless patients
Provide meals, food, vouchers or money for transportation or reimburse costs depending on context and patient needs

From the guideline

Verbatim

“Due to the toxicity and long duration of treatment, patients on DR-TB treatment usually require substantial support.”

— Médecins Sans Frontières, Therapeutic patient education and patient support services — MSF Tuberculosis, Section 13.4 (2026)

Editor’s perspective

Why this matters for Georgia and the region

Prof. Giorgi Pkhakadze, MD, MPH, PhD

Editor-in-Chief, Georgian Medical Journal · Chair, Public Health Institute of Georgia · WHO consultant, health and migration

As Chair of the Public Health Institute of Georgia and having consulted on tuberculosis control programmes across the region, I recognise that this MSF guidance addresses critical gaps in our national TB programmes. Georgia has made substantial progress in tuberculosis case detection and treatment, but patient retention and adherence—particularly for the 10-15% of cases that are drug-resistant—remain challenging. The emphasis on multidisciplinary support, including mental health screening and social assistance, aligns with evidence that psychosocial factors are major determinants of treatment outcomes in our context. The realistic caveat for implementation in Georgia and neighbouring countries is that most TB programmes lack dedicated social workers and counsellors, and integrating these cadres will require sustainable financing beyond vertical disease programmes, ideally through our existing universal health coverage frameworks.

ORCID 0000-0001-7609-4515 · Perspective written for the GMJ Guidelines Library, 23 Oct 2026

Applicability

Georgia and the South Caucasus

Georgia’s National TB Programme, which manages over 1,000 tuberculosis cases annually including a significant proportion of drug-resistant cases, would benefit from strengthening patient support services as outlined in this guidance. National programmes in the South Caucasus and Eastern Europe, where DR-TB prevalence remains among the highest globally, should consider integrating multidisciplinary teams including social workers and counsellors, establishing transportation support schemes for rural patients facing geographic barriers, and training healthcare workers in mental health screening given the documented high prevalence of depression and anxiety among TB patients in the region.

Questions this guideline answers

Quick answers

Who should provide therapeutic patient education and support for TB patients?

The entire healthcare team should be involved, including clinicians, nurses, treatment supporters, social workers and trained counsellors who provide information and support.

What channels can be used to deliver patient education and support?

Educational sessions during in-facility visits, home visits, video contacts and telephone contacts can all be used to provide therapeutic patient education and support.

Why do patients on DR-TB treatment need more support?

Due to the toxicity and long duration of DR-TB treatment, patients usually require substantial support throughout their treatment course.

What types of social support should be provided to TB patients with limited resources?

Depending on context and patient needs, programmes can help obtain disability allowances, housing assistance, shelter for the homeless, provide meals or food, and offer vouchers or money for transportation or reimburse travel costs.

Related on GMJ

Interconnected resources

Dictionary of Public Health

Conditions A–Z

GMJ News coverage

Quality & accreditation

ASF Hospital — Standard 15 — Psychiatry & Mental Health

Same guideline

Factors that influence adherence — MSF TuberculosisChapter 13: Adherence to tuberculosis treatment
Treatment delivery model — MSF TuberculosisChapter 13: Adherence to tuberculosis treatment
Immune Reconstitution Inflammatory Syndrome in TB-HIV Co-infection — MSF TuberculosisChapter 12: Tuberculosis and HIV co-infection
Concomitant treatment of tuberculosis and HIV co-infection — MSF TuberculosisChapter 12: Tuberculosis and HIV co-infection
Standard treatment regimen for isoniazid-resistant tuberculosis — MSF TuberculosisChapter 11: Treatment of rifampicin-susceptible and isoniazid-resistant tuberculosis
Treatment of rifampicin-susceptible and isoniazid-resistant tuberculosis — Introduction — MSF TuberculosisChapter 11: Treatment of rifampicin-susceptible and isoniazid-resistant tuberculosis

Therapeutic patient education and patient support services — MSF Tuberculosis

What this guideline says

Key points

From the guideline