Contracts between patients and healthcare practitioners for improving patients' adherence to treatment, prevention and health promotion activities

Capblanch, X Bosch; Garner, Paul

doi:10.1002/14651858.cd004808.pub2

Cited by 11 publications

(11 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In their clinical review, Chan 2002 reported that direct observation is essential and effective for treatment and, by extension, TB elimination. The review was not systematic and mainly looked at areas where DOT has been done in conjunction with other interventions.…”

Section: Discussionmentioning

confidence: 99%

Directly observed therapy for treating tuberculosis

Volmink

Garner

2015

Cochrane Database of Systematic Reviews

389

212

View full text Add to dashboard Cite

Background Tuberculosis (TB) requires at least six months of treatment. If treatment is incomplete, patients may not be cured and drug resistance may develop. Directly Observed Therapy (DOT) is a specific strategy, endorsed by the World Health Organization, to improve adherence by requiring health workers, community volunteers or family members to observe and record patients taking each dose. Objectives To evaluate DOT compared to self‐administered therapy in people on treatment for active TB or on prophylaxis to prevent active disease. We also compared the effects of different forms of DOT. Search methods We searched the following databases up to 13 January 2015: the Cochrane Infectious Diseases Group Specialized Register; the Cochrane Central Register of Controlled Trials (CENTRAL), published in the Cochrane Library; MEDLINE; EMBASE; LILACS and m RCT. We also checked article reference lists and contacted relevant researchers and organizations. Selection criteria Randomized controlled trials (RCTs) and quasi‐RCTs comparing DOT with routine self‐administration of treatment or prophylaxis at home. Data collection and analysis Two review authors independently assessed risk of bias of each included trial and extracted data. We compared interventions using risk ratios (RR) with 95% confidence intervals (CI). We used a random‐effects model if meta‐analysis was appropriate but heterogeneity present (I 2 statistic > 50%). We assessed the quality of the evidence using the GRADE approach. Main results Eleven trials including 5662 participants met the inclusion criteria. DOT was performed by a range of people (nurses, community health workers, family members or former TB patients) in a variety of settings (clinic, the patient's home or the home of a community volunteer). DOT versus self‐administered Six trials from South Africa, Thailand, Taiwan, Pakistan and Australia compared DOT with self‐administered therapy for treatment. Trials included DOT at home by family members, community health workers (who were usually supervised); DOT at home by health staff; and DOT at health facilities. TB cure was low with self‐administration across all studies (range 41% to 67%), and direct observation did not substantially improve this (RR 1.08, 95% CI 0.91 to 1.27; five trials, 1645 participants, moderate quality evidence ). In a subgroup analysis stratified by the frequency of contact between health services in the self‐treatment arm, daily DOT may improve TB cure when compared to self‐administered treatment where patients in the self‐administered group only visited the clinic every month (RR 1.15, 95% CI 1.06 to 1.25; two trials, 900 participants); but with contact in the control becoming more frequent, this small effect was not apparent (every two...

show abstract

Section: Discussionmentioning

confidence: 99%

Directly observed therapy for treating tuberculosis

Volmink

Garner

2015

Cochrane Database of Systematic Reviews

389

212

View full text Add to dashboard Cite

show abstract

“…These nclude interventions promoting better health care provider-patient communication about adherence; developing or improving existing adherence support services that are offered by a multidisciplinary team (nurse, physician, pharmacy, patient etc.) [6]; directly observed therapy (which involves a health care worker, community care worker or family member directly monitoring patients swallowing their TB medication) [4]; staff motivation and supervision [4]; education and counseling [7]; reminder systems and late patient tracers to help patients keep appointments [8]; incentives and enablers [9]; contracts (that is written or verbal agreements) to return for appointment or course of treatment; and social support to assist the patient in being adherent, provided by community healthcare workers [10] or patient groups [6]. These interventions or complex combinations of the interventions may need to be employed to promote TB medication adherence.…”

Section: Introductionmentioning

confidence: 99%

Mobile phone text messaging for promoting adherence to anti-tuberculosis treatment: a systematic review

et al. 2013

View full text Add to dashboard Cite

BackgroundMobile phone text messaging (SMS) has the potential to promote adherence to tuberculosis treatment. This systematic review aims to synthesize current evidence on the effectiveness of SMS interventions in improving patients’ adherence to tuberculosis treatment.MethodsWe searched electronic databases (PubMed, EMBASE, Science Citation Index), reference lists of relevant articles, conference proceedings, and selected websites for eligible studies available by 15 February 2013; regardless of language or publication status. Two authors independently screened selected eligible studies, and assessed risk of bias in included studies; resolving discrepancies by discussion and consensus.ResultsWe identified four studies that compared the outcomes of the SMS intervention group with controls. Only one of the four studies was a randomized controlled trial. This was conducted in Argentina and the SMS intervention did not significantly improve adherence to tuberculosis treatment compared to self-administration of tuberculosis treatment (risk ratio [RR] 1.49, 95% confidence intervals [CI] 0.90 to 2.42). One of the non-randomized studies, conducted in South Africa, which compared SMS reminders to directly observed therapy short course (DOTS) reported similar rates of tuberculosis cure (62.35% vs. 66.4%) and treatment success (72.94% vs. 69.4%). A second study from South Africa, utilized SMS reminders when patients delayed in opening their pill bottles and reported increased tuberculosis cure (RR 2.32, 95% CI 1.60 to 3.36) and smear conversion (RR 1.62, 95% CI 1.09 to 2.42) rates compared to DOTS. In the third non-randomized study, conducted in Kenya, use of SMS reminders increased rates of clinic attendance on scheduled days compared to standard care (RR 1.56, 95% CI 1.06 to 2.29). Using the GRADE approach, we rate the quality of the evidence as low, mainly because of the high risk of bias and heterogeneity of effects across studies.ConclusionsThis systematic review indicates that there is a paucity of high-quality data on the effectiveness of SMS interventions for improving patients’ adherence to tuberculosis treatment. The low quality of the current evidence implies that further studies (in particular randomized trials) on the subject are needed. In the interim, if the intervention is implemented outside research settings an impact evaluation is warranted.

show abstract

“…We list excluded reviews of financial arrangements in Table 3. We excluded 13 reviews because of important methodological limitations (Ekman 2004; Ensor 2004; Buchmueller 2005; Attree 2006; De Janvry 2006; Siddiqi 2007; Patouillard 2007; Lagarde 2008; Bhutta 2009; Lee 2009; Bellows 2011; Faden 2011; Meyer 2011), 6 for being out-of-date (Giuffrida 1997; Giuffrida 1999; Bock 2001; Gosden 2001; Forbes 2002; Kane 2004), 25 because a more relevant review was available (WHO 1996; Chaix-Couturier 2000; Giuffrida 2000; Gosden 2000; WHO 2003; Borghi 2006; Doran 2006; Eichler 2006; Handa 2006; Lagarde 2006; Petersen 2006; Rosenthal 2006; Bosch-Capblanch 2007; Lagarde 2007; Gemmill 2008; Mannion 2008; Oxman 2008; Sutherland 2008; Barnighausen 2009; Fournier 2009; Lawn 2009; Van Herck 2010; WHO 2010b; Petry 2012; Yoong 2012), and 1 because it was not transferable to low-income countries (Lucas 2008). Appendix 4 lists the reviews still awaiting classification.…”

Section: Resultsmentioning

confidence: 99%

Financial arrangements for health systems in low-income countries: an overview of systematic reviews

Wiysonge

Paulsen

Lewin

et al. 2017

Cochrane Database of Systematic Reviews

102

View full text Add to dashboard Cite

BackgroundOne target of the Sustainable Development Goals is to achieve "universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all". A fundamental concern of governments in striving for this goal is how to finance such a health system. This concern is very relevant for low-income countries.ObjectivesTo provide an overview of the evidence from up-to-date systematic reviews about the effects of financial arrangements for health systems in low-income countries. Secondary objectives include identifying needs and priorities for future evaluations and systematic reviews on financial arrangements, and informing refinements in the framework for financial arrangements presented in the overview.MethodsWe searched Health Systems Evidence in November 2010 and PDQ-Evidence up to 17 December 2016 for systematic reviews. We did not apply any date, language, or publication status limitations in the searches. We included well-conducted systematic reviews of studies that assessed the effects of financial arrangements on patient outcomes (health and health behaviours), the quality or utilisation of healthcare services, resource use, healthcare provider outcomes (such as sick leave), or social outcomes (such as poverty, employment, or financial burden of patients, e.g. out-of-pocket payment, catastrophic disease expenditure) and that were published after April 2005. We excluded reviews with limitations important enough to compromise the reliability of the findings. Two overview authors independently screened reviews, extracted data, and assessed the certainty of evidence using GRADE. We prepared SUPPORT Summaries for eligible reviews, including key messages, 'Summary of findings' tables (using GRADE to assess the certainty of the evidence), and assessments of the relevance of findings to low-income countries.Main resultsWe identified 7272 reviews and included 15 in this overview, on: collection of funds (2 reviews), insurance schemes (1 review), purchasing of services (1 review), recipient incentives (6 reviews), and provider incentives (5 reviews). The reviews were published between 2008 and 2015; focused on 13 subcategories; and reported results from 276 studies: 115 (42%) randomised trials, 11 (4%) non-randomised trials, 23 (8%) controlled before-after studies, 51 (19%) interrupted time series, 9 (3%) repeated measures, and 67 (24%) other non-randomised studies. Forty-three per cent (119/276) of the studies included in the reviews took place in low- and middle-income countries.Collection of funds: the effects of changes in user fees on utilisation and equity are uncertain (very low-certainty evidence). It is also uncertain whether aid delivered under the Paris Principles (ownership, alignment, harmonisation, managing for results, and mutual accountability) improves health outcomes compared to aid delivered without conforming to those principles (very low-certainty evidence).Insuranc...

show abstract

Contracts between patients and healthcare practitioners for improving patients' adherence to treatment, prevention and health promotion activities

Cited by 11 publications

References 31 publications

Directly observed therapy for treating tuberculosis

Directly observed therapy for treating tuberculosis

Mobile phone text messaging for promoting adherence to anti-tuberculosis treatment: a systematic review

Financial arrangements for health systems in low-income countries: an overview of systematic reviews

Contact Info

Product

Resources

About