Choice‐Based Reminder Cues: Findings From an mHealth Study to Improve Tuberculosis (TB) Treatment Adherence Among the Urban Poor in India

Abstract

Poor treatment outcomes due to nonadherence and consequent high levels of drug resistance continue to challenge efforts to combat tuberculosis (TB) in India. Mobile health‐ or mHealth‐based reminder cues have been considered in multiple health behavior modification interventions, including TB treatment nonadherence. We conducted a quasi‐experimental study in Ahmedabad, India, to examine the effectiveness of mHealth‐based reminder cues customized to meet diverse patient needs. Results from this experiment indicate that the potential of customized mHealth reminder cues may remain unrealized unless addressed in conjunction with the multifaceted drivers of TB treatment nonadherence. The perspective we present here has broad relevance for future mHealth studies, especially in interpreting challenges that arise within resource‐scarce settings of the urban poor and prevent them from adhering to recommended TB treatment regimens.

A Scoping Review on Accentuating the Pragmatism in the Implication of Mobile Health (mHealth) Technology for Tuberculosis Management in India

“…The main reason for substandard treatment outcome is non-adherence to therapy protocol [ 43 ]. mHealth related reminders in the form of interactive text messages or voice calls that are human assisted instead of whole automation are deemed to be the most welcoming intervention [ 44 , 45 ].…”

Contextual factors influencing implementation of tuberculosis digital adherence technologies: a scoping review guided by the RE-AIM framework

“…Some people with TB conveyed dissatisfaction with DATs, because the technologies inadequately addressed critical problems contributing to nonadherence, such as medication adverse effects, alcohol use, or drug stockouts. [17,31,34] People with TB also described technology fatigue, as they felt overwhelmed by frequent notifications and texting or calling requirements, resulting in "decreased interest" [75] and motivation to engage with the DAT. [51,67,73,75] With regard to the UTAUT construct of ease of use, meta-themes had findings from several studies, suggesting that these barriers strongly limit reach of some DATs.…”