No1Lost – Competence Network for Tuberculosis Therapy Adherence
The No1Lost project is a collaborative initiative funded by the Federal Ministry of Health (BMG) of Germany, involving the German Central Committee against Tuberculosis (DZK), the Justus Liebig University Giessen, and the foundation CAPNETZ STIFTUNG, with the aim of improving treatment adherence among tuberculosis (TB) patients in Germany.
Duration: July 1, 2024 to June 30, 2027.
Background : Despite the availability of modern diagnostic and treatment options, TB remains one of the most deadly infectious diseases worldwide. While the number of cases of TB in Germany remains low, there has been an increase in cases among vulnerable risk groups, which require good interdisciplinary care. Despite the availability of effective treatment regimens, many patients fail to complete the treatment, particularly in cases of multidrug-resistant TB (MDR-TB). The objective of the No1Lost project is therefore to conduct a comprehensive analysis of the care structures for tuberculosis in Germany in order to identify the underlying reasons for treatment discontinuation. The project aims to enhance interdisciplinary care and, through the provision of social-medical support, to facilitate adherence to treatment for individuals diagnosed with tuberculosis.
A preparatory study showed that the current approach to patient care currently relies heavily on the individual commitment of the professionals involved and that the social medical support required is often not adequately financed. The participants of this study identified two immediate priorities: (i) the need to establish a robust network of medical and social medical professional to ensure continued adherence to therapy and (ii) improved personal communication and interaction with TB patients.
Overview of some central contents of the No1Lost project
Establishment of a nationwide competence network for therapy adherence:
- Establishment of a barrier-free, interactive Internet platform
- Development of a digital map showing regional networks and support options
- Counseling services for those involved in care provided by an interdisciplinary network of experts
- Platform for regional networking
Research into why patients don’t complete tuberculosis treatment:
- Conducting a prospective cohort study to identify clinical and sociomedical risk factors in patients with MDR-TB, who are particularly at risk of treatment discontinuation
- Analysis of the care structures for tuberculosis in Germany and the existing barriers and enhancers for therapy adherence through qualitative and quantitative research in the competence network for therapy adherence
Support for medical care:
- Provision of practical tools and best practice examples for social medical support
- Organization of interdisciplinary clinical case meetings to discuss complex social-medical issues
Overcoming language and cultural barriers:
Enhance communication between patients and healthcare providers through translators/interpreters to overcome language and cultural difference barrier, thereby fostering better personal interaction and trust
Offer of further training:
Development and implementation of training courses for patient-centered, social-medical support and communication with TB patients
In order to facilitate the identification of specialized providers for MDR-TB in Germany and to provide an overview of local contact points, the DZK has developed an interactive network map as part of the No1Lost project. The map depicts the German MDR-TB network, which currently encompasses 60 clinics. Additionally, outpatient specialist medical care (ASV) for TB has been incorporated based on data from the ASV service center.
By publishing the current status, we aim to encourage people to join the network. It should be noted that the networks shown on the map do not fully represent the healthcare landscape in Germany. If a healthcare facility is missing, please contact the DZK (info@dzk-tuberkulose.de).
