Appendix 4: LTBI Card Instructions and Education –

Treatment Started/Completed (English)

At Beginning of Treatment

·  Provide educational messages to the patient about the significance of the positive TB test and the importance of completing treatment for LTBI. Patient and provider educational materials that may assist are available on CDC’s website: http://www.cdc.gov/tb/pubs/default.htm).

·  Show Gold LTBI Card to the patient and say:

§  Congratulations on your decision to start treatment for LTBI

§  When you have finished your treatment and taken all of your pills, I will give a Gold Card called Your TB Test and Treatment Record

§  You should keep this card in your wallet at all times and show it every time you go to a new doctor or clinic

§  The card will tell the doctor that:

§  Your TB test is already positive and that you don’t have to be tested again.

§  Your chest x-ray does not show TB disease

§  You have completed treatment and do not have to be treated again

§  Do have any questions?

During Treatment

·  During each follow up visit, use the LTBI Card Poster to re-emphasize the importance of completing treatment and the value of receiving the LTBI “Gold Card” upon treatment completion

At the Completion of Treatment

·  Congratulate the patient on finishing treatment for LTBI

·  Provide educational messages to patient about the protection the treatment provides and the importance of going to a doctor or clinic if signs of TB disease develop (as listed on LTBI Card)

·  Complete the Gold Copy of the LTBI Card

§  Record the patient’s Name and date of birth (DOB)

§  Record the TST Result in mm of induration and Date Read or record the QFT Result and Date

§  Record the Chest X-Ray Date and check the Result

§  Check Treatment Completed and record Name of Drug(s), Dates Started and Stopped, and the number of months medication was taken

·  Make a copy of the Card and place the copy in the patient’s medical record

·  Laminate the Card

·  Give Gold Card to patient and say:

§  This Gold Card is your permanent TB Test and Treatment Record

§  Keep this card in your wallet and show it every time you go to a new doctor or clinic

§  This card will tell the doctor that:

§  Your TB test is already positive and that you don’t have to be tested again

§  Your chest x-ray does not show TB disease

§  You have completed treatment and that you don’t have to be treated again

§  These tests and treatment won't be necessary if you just show this card to your doctor

§  Do you have any questions?