Objectives: This study examined how patient acceptability influences the effectiveness of directly observed therapy for tuberculosis.
Methods: Decision and sensitivity analyses were used in assessing influences.
Results: If mandatory directly observed therapy discourages 6% of initial tuberculosis patients (range: 4% to 10%) from seeking care, then such therapy will be less effective than self-administered therapy. Directly observed therapy is more effective than repeated self-administered therapy for patients failing to complete initial treatment unless 32% (range: 27% to 38%) of patients avoid seeking care.
Conclusions: Patient acceptability must be taken into consideration before selecting public health strategies.