Patient-Centered Digital Interventions for Self-Care Ability Among People with Pulmonary Tuberculosis: A Systematic Review

Abstract

Tuberculosis remains a significant global health issue, with adherence to treatment essential for positive outcomes. This systematic review evaluated the effectiveness of patient-centered digital interventions (e.g., mobile health apps, SMS reminders, video-observed therapy) in promoting self-care behaviors among people with pulmonary tuberculosis and identified implementation challenges. A review of studies published between 2019 and 2024 was conducted across six databases, guided by the PRISMA framework. Eligible studies included adults with pulmonary tuberculosis, utilized digital interventions and reported outcomes on treatment adherence, completion rates, patient knowledge, quality of life, cost-effectiveness, and satisfaction. The study designs consisted of randomized controlled trials, quasi-experimental studies, and observational studies with control groups. Data were synthesized narratively due to heterogeneity in interventions and outcomes. Twenty studies from 12 countries, involving over 9,000 participants, were included. Digital interventions showed significant improvements in treatment adherence in six out of ten studies, but evidence for improved completion rates was less conclusive. Patients generally found digital interventions acceptable and satisfactory. Implementation challenges included technological barriers, connectivity issues, and privacy concerns. Facilitators included user-friendly design, contextual customization, and adequate support. Patient-centered digital interventions promise to enhance treatment adherence for pulmonary tuberculosis but have fewer clear effects on completion rates. Future research should address identified challenges and explore long-term impacts on patient knowledge and quality of life.