Effect of mobile health reminders on tuberculosis treatment outcomes in Shanghai, China: A prospective cohort study

A meta-analysis of technology-based interventions on treatment adherence and treatment success among TBC patients

Various technology-based interventions have been designed to improve medication adherence and treatment success. However, research on the most effective mode to address this issue is still limited. Our study evaluated the effectiveness of technology-based interventions in improving treatment adherence, completion, and treatment success among tuberculosis (TBC) patients. We conducted a meta-analysis of randomized controlled trials by searching articles from six databases including PubMed, Science Direct, Cochrane, Jstor, Embase, and Scopus from 2018 to April 2023. Two independent reviewers assessed the study quality using the Cochrane Risk of Bias 2.0 tool. We analysed the data using a random-effects model. We also conducted publication bias and sensitivity analysis. In total, 13 studies were identified and 4,794 participants were included in the meta-analysis. The results indicated that technology-based interventions were effective in improving treatment adherence, completion, and success (Odds Ratio (OR): 2.57, 95% Confident Interval (CI): 1.01-6.50, I2 = 86.6%; OR: 1.77, 95% CI: 0.95-3.28, I2: 82.3%; OR: 1.61, 95% CI: 0.85-3.06, I2: 84%, respectively). We examined the possibility of publication bias in the published studies included in this systematic review. However, no evidence of publication bias was found. From the sensitivity analysis by removing one study randomly, we found that our results are robust. Based on the results, we can conclude that technology-based interventions like MERM, text-based messages, video conferencing, and VOT are effective in increasing treatment adherence and completion in tuberculosis management. Therefore, technology shows immense potential in enhancing patient outcomes.

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

Background

High-quality medication compliance is critical for the cure of pulmonary tuberculosis (PTB); however, the implementation of directly observed treatment (DOT) under direct interview still faces huge difficulties. Assessment of the effect of digital tool during community management has not been performed in eastern China.

Methods

All drug-sensitive PTB cases notified in Yiwu city from June to December 2020 were divided into the routine group and digital tool group based on patients' willingness. The variables influencing the on-time completion level of home visits, medication adherence and treatment outcomes were estimated.

Results

A total of 599 eligible patients were enrolled, with 268 participating in the routine group and 331 using a digital tool. Most participants were men (n = 357, 59.6%), and nearly all were new cases (n = 563, 94.0%). Participants' mean age was 44.22 ± 20.32 years. There were significant differences in age, diagnostic type, and source of patients between the two groups. During the study period, the digital tool group had a higher on-time completion rate of home visits (91.5% vs. 82.5%) and medication adherence rate (94.3% vs. 89.6%) than the routine group, whereas there was no significant difference in the treatment success rate between the two groups (91.2% vs. 86.8%). Multivariate logistic regression analysis demonstrated that the digital tool group showed a more positive function in the on-time completion status of home visits, with an adjusted odds ratio of 0.41 (95% confidence interval: 0.25-0.70).

Conclusion

Digital tools can be employed to improve the on-time completion rate of home visits in Yiwu city. Further large-scale studies that use digital tools for community management are warranted.