3.8. Directly observed therapy (DOT)
Those patients receiving medicines through DOT (n = 9) spoke
of the benefits in terms of contact with ‘normal people’ and ‘female
company’ (for some homeless men), support from staff, and the
structure the clinic visits afforded:
‘‘. . .the day I’m not going to the clinic it’s difficult to get up. It’s
my day out’’ (ID01).
For PWID, DOT was provided at a number of locations including
the Drug Dependency Unit (DDU) or pharmacist in conjunction
with methadone, the hostel via outreach workers, or the TB clinic.
However DOT was not always successful even where the location
or provider changed. PWID did not always attend the DDU, either
because of the distance they had to travel, or because they had used
or intended to obtain drugs. The monitoring of pill swallowing also
varied across different healthcare locations; whereas some staff
made distinct efforts to check that all pills had been swallowed