A randomised controlled trial to evaluate a medication monitoring system for TB treatment

Acosta, José A.; Flores, Paula Vanessa Peclat; Alarcón, MD López; Grande-Ortiz, Miguel; Moreno-Exebio, Luis; Puyén, Zully M.

doi:10.5588/ijtld.21.0373

Cited by 24 publications

(28 citation statements)

References 21 publications

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“…On single outcomes by cascade, 11 (12.2%) studies reported TB testing outcomes [ 28 – 38 ], 22 (23.9%) reported TB diagnosis [ 39 – 57 ], 15 (16.3%) reported on linkage to care [ 58 – 74 ], 21 (22.8%) studies reported treatment completion [ 11 , 12 , 75 – 94 ], 9 (9.8%) reported on cure [ 14 , 80 , 95 – 102 ], and 14 (15.2%) studies reported on treatment success [ 80 , 103 – 116 ].…”

Section: Resultsmentioning

confidence: 99%

Improving cascade outcomes for active TB: A global systematic review and meta-analysis of TB interventions

Marley

Zou

Nie³

et al. 2023

PLoS Med

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Background To inform policy and implementation that can enhance prevention and improve tuberculosis (TB) care cascade outcomes, this review aimed to summarize the impact of various interventions on care cascade outcomes for active TB. Methods and findings In this systematic review and meta-analysis, we retrieved English articles with comparator arms (like randomized controlled trials (RCTs) and before and after intervention studies) that evaluated TB interventions published from January 1970 to September 30, 2022, from Embase, CINAHL, PubMed, and the Cochrane library. Commentaries, qualitative studies, conference abstracts, studies without standard of care comparator arms, and studies that did not report quantitative results for TB care cascade outcomes were excluded. Data from studies with similar comparator arms were pooled in a random effects model, and outcomes were reported as odds ratio (OR) with 95% confidence interval (CI) and number of studies (k). The quality of evidence was appraised using GRADE, and the study was registered on PROSPERO (CRD42018103331). Of 21,548 deduplicated studies, 144 eligible studies were included. Of 144 studies, 128 were from low/middle-income countries, 84 were RCTs, and 25 integrated TB and HIV care. Counselling and education was significantly associated with testing (OR = 8.82, 95% CI:1.71 to 45.43; I2 = 99.9%, k = 7), diagnosis (OR = 1.44, 95% CI:1.08 to 1.92; I2 = 97.6%, k = 9), linkage to care (OR = 3.10, 95% CI = 1.97 to 4.86; I2 = 0%, k = 1), cure (OR = 2.08, 95% CI:1.11 to 3.88; I2 = 76.7%, k = 4), treatment completion (OR = 1.48, 95% CI: 1.07 to 2.03; I2 = 73.1%, k = 8), and treatment success (OR = 3.24, 95% CI: 1.88 to 5.55; I2 = 75.9%, k = 5) outcomes compared to standard-of-care. Incentives, multisector collaborations, and community-based interventions were associated with at least three TB care cascade outcomes; digital interventions and mixed interventions were associated with an increased likelihood of two cascade outcomes each. These findings remained salient when studies were limited to RCTs only. Also, our study does not cover the entire care cascade as we did not measure gaps in pre-testing, pretreatment, and post-treatment outcomes (like loss to follow-up and TB recurrence). Conclusions Among TB interventions, education and counseling, incentives, community-based interventions, and mixed interventions were associated with multiple active TB care cascade outcomes. However, cost-effectiveness and local-setting contexts should be considered when choosing such strategies due to their high heterogeneity.

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Section: Resultsmentioning

confidence: 99%

Improving cascade outcomes for active TB: A global systematic review and meta-analysis of TB interventions

Marley

Zou

Nie³

et al. 2023

PLoS Med

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“…Reminders have also been explored for improving adherence to tuberculosis treatment in endemic countries. A higher frequency of treatment success was shown in a medication event reminder group (MERM) compared to the traditional directly observed group in one study conducted in Peru [41].…”

Section: Remindersmentioning

confidence: 99%

Assessment of factors and interventions towards therapeutic adherence among persons with non-cystic fibrosis bronchiectasis

Thornton

Somayaji²,

Lim³

2022

ERJ Open Res

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Non-cystic fibrosis bronchiectasis (NCFB) is a highly prevalent chronic respiratory disease with substantial burden to both patients and health care systems. Persons with NCFB (pwNCFB) are often given complex acute and chronic treatment regimens consisting of medications, airway clearance techniques and exercise. Accordingly, the high burden in NCFB has contributed to lower therapy adherence with estimates of 53% to medications, 41% to airway clearance and only 16% to all prescribed therapy. Consequent clinical outcomes from lower adherence include reduced quality of life, accelerated lung function decline and recurrent pulmonary exacerbations. In this narrative review, we explore the impact of multifactorial mechanisms underpinning adherence in NCFB and evaluate the available evidence towards interventions to improve uptake of therapy as demonstrated in other chronic respiratory diseases. A holistic approach, starting with a careful review of patient adherence at regular intervals, may increase the success of multidimensional therapeutic interventions in pwNCFB, but robust ongoing studies are an area of need in this population.

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“…Studies suggest adherence interventions for improving outcomes, such as medication event reminder monitor (MERM) systems, electronic pillboxes, and text messaging [ 10 , 11 ]. Medication reminders appear to improve compliance and staff-patient relationships, but have not been shown to cause significant differences in treatment success [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Mobile application development for improving medication safety in tuberculosis patients: A quasi-experimental study protocol

et al. 2022

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The COVID-19 pandemic, the growth of smartphones, and the internet have driven the use of technology for monitoring TB patients. Innovation in management of TB patients is needed to improve treatment outcomes. The study was conducted to obtain a predictive model of medication safety and solution model for at-risk patients, and to improve medication safety through mobile applications. The research was conducted in 4 stages, namely qualitative, quantitative (cross-sectional), qualitative, and quantitative (quasi-experimental, post-test group control design). Data were taken at the Public Health Center in Jakarta, Indonesia. Samples were taken by cluster random sampling. For quantitative research, 2nd phase (n = 114) and 4th phase (n = 96) were analyzed using logistic regression. This study analyzed predictors of medication safety to assist in monitoring patients undergoing treatment. At-risk patients were educated using an algorithm programmed in the application.

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A randomised controlled trial to evaluate a medication monitoring system for TB treatment

Cited by 24 publications

References 21 publications

Improving cascade outcomes for active TB: A global systematic review and meta-analysis of TB interventions

Improving cascade outcomes for active TB: A global systematic review and meta-analysis of TB interventions

Assessment of factors and interventions towards therapeutic adherence among persons with non-cystic fibrosis bronchiectasis

Mobile application development for improving medication safety in tuberculosis patients: A quasi-experimental study protocol

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