Digitizing tuberculosis treatment monitoring in Wuhan city, China, 2020–2021: Impact on medication adherence

Abstract

IntroductionDigital technologies can improve adherence to tuberculosis (TB) treatment. We studied the impact of digitizing TB treatment monitoring on adherence among TB patients in Wuhan, China, during 2020-2021.MethodsWe compared an electronic system introduced to monitor TB medication adherence (e-Patient Service System; e-PSS) with the p paper-based standard of care (TB Control Information System; TCIS) in terms of prescribed TB treatment doses taken by patients and patient outcome after six months of follow up. We designed a cross sectional study using retrospective data for all drug susceptible pulmonary TB patients recorded on both systems. The main indicators were: compliant first follow up visit (within 3 days of start of treatment); medication adherence (80% or more of monthly doses taken); and end of treatment success ratio.ResultsA total of 1,576 TB patients were recorded in TCIS in July September, 2020 and 1,145 TB cases were included in e-PSS in January March, 2021. The distribution of patient demographic and clinical features was similar between the two groups. A larger proportion from the e-PSS group visited the community doctor in the first three days compared with the TCIS group (48.91 versus 29. 76 % respectively). Medication adherence was also higher in the e-PSS group during the 6 months of treatment than in the TCIS group (84. 28 versus 80.3 3 % respectively). Treatment success was 92.52% in the e-PSS group and 92.07% in the TCIS group. Multivariate logistic regress ion analysis demonstrated that adjusted odds ratios for compliant first follow up visit, medication adherence and favorable treatment outcome in the e-PSS versus TCIS groups were 2.94 (95% 2.47 3.50), 1.33 (95% 1.08 1.63), and 1. 12 (95% CL: 0.79 1.57) respectively.DiscussionThis study revealed improvements in TB care following an intervention to monitor treatment digitally in patients in Wuhan, China.

The Impact of Digital Adherence Technologies on Health Outcomes in Tuberculosis: A Systematic Review and Meta-Analysis

“…While one study[35] suggested that the technology was associated with an improvement in treatment adherence of persons with multi-drug resistant TB, the two other studies found conflicting results among persons with drug-sensitive TB. [36,37]…”

“…[19,20,29,48,52] Similarly, for interventions that involved smartphone technologies, most studies described various combinations of associated measures e.g., medication reminders, adverse event reporting, instant messaging, chat groups with providers and/or other patients. [37,53,54] The diversity of comparison strategies reported as the "standard of care" further complicates This substantially limits generalizability of findings regarding these two technologies to lowerincome country settings where TB burden is highest, yet where these technologies and the necessary technical and human resource infrastructure may be least accessible. Notably, however, our review does report robust findings from studies in LMICs: the DAT types implemented in these settings (e.g., SMS, 99DOTS, digital pillboxes) had variable or nonsignificant impacts on treatment outcomes, which has important policy implications.…”

“…[19,20,29,48,52] Similarly, for interventions that involved smartphone technologies, most studies described various combinations of associated measures e.g., medication reminders, adverse event reporting, instant messaging, chat groups with providers and/or other patients. [37,53,54]…”

Digital tool assessment for the community management of patients with pulmonary tuberculosis in Yiwu city, China: evidence from real world data in 2020

“…The digital tool provided two options to patients—the reminder application or reminder smart pillbox—while one management application along with a management website were provided for medical staff to monitor patients’ medication adherence. A detailed description of tool utilization was introduced previously ( 17 , 18 ).…”

Gratitude Dengan Stres Pasien Tuberkulosis Paru

“…Sembuh dari tuberkulosis juga membuat mereka lebih menghargai kesehatan dan nilai sumber daya alam yang mendukung kehidupan. Penelitian ini sesuai dengan penelitian yang menyatakan tipe pekerjaan seseorang juga memengaruhi penghasilan keluarga, yang pada gilirannya berdampak pada gaya hidup sehari-hari, termasuk pola makan yang sehat dan pemeliharaan kesehatan (Zhang et al, 2023). Sejalan dengan penelitian lainnya yang menyatakan potensi adanya faktor psikologis seperti kecenderungan alami untuk bersyukur atau sikap optimis seorang petani yang dapat membentuk pandangan positif terhadap hidup sehingga memiliki gratitude tinggi (Wnuk, 2020).…”