Digital adherence technologies for the management of tuberculosis therapy: mapping the landscape and research priorities
Ramnath Subbaraman
de Mondesert Laura
Musiimenta, Angella
Pai Madhukar
Kenneth H Mayer
Beena E. Thomas
Jessica Haberer
10.25376/hra.7385048.v1
https://hra.figshare.com/articles/journal_contribution/Digital_adherence_technologies_for_the_management_of_tuberculosis_therapy_mapping_the_landscape_and_research_priorities/7385048
Poor medication adherence may increase rates of loss to follow-up, disease relapse and drug resistance for individuals with active tuberculosis (TB). While TB programmes have historically used directly observed therapy (DOT) to address adherence, concerns have been raised about the patient burden, ethical limitations, effectiveness in improving treatment outcomes and long-term feasibility of DOT for health systems. Digital adherence technologies (DATs)-which include feature phone-based and smartphone-based technologies, digital pillboxes and ingestible sensors-may facilitate more patient-centric approaches for monitoring adherence, though available data are limited. Depending on the specific technology, DATs may help to remind patients to take their medications, facilitate digital observation of pill-taking, compile dosing histories and triage patients based on their level of adherence, which can facilitate provision of individualised care by TB programmes to patients with varied levels of risk. Research is needed to understand whether DATs are acceptable to patients and healthcare providers, accurate for measuring adherence, effective in improving treatment outcomes and impactful in improving health system efficiency. In this article, we describe the landscape of DATs that are being used in research or clinical practice by TB programmes and highlight priorities for research
2018-11-26 22:33:05
tuberculosis control programs
mHealth technology
medication adherence-related concerns
Medical Bacteriology