The impact of digital health technologies on tuberculosis treatment: a systematic review

Brian Kermu Ngwatu, Ntwali Placide Nsengiyumva, Olivia Oxlade, Benjamin Mappin-Kasirer, Nhat Linh Nguyen, Ernesto Jaramillo, Dennis Falzon, Kevin Schwartzman, Collaborative group on the impact of digital technologies on TB, Brian Kermu Ngwatu, Ntwali Placide Nsengiyumva, Olivia Oxlade, Benjamin Mappin-Kasirer, Nhat Linh Nguyen, Ernesto Jaramillo, Dennis Falzon, Kevin Schwartzman, Collaborative group on the impact of digital technologies on TB

Abstract

Digital technologies are increasingly harnessed to support treatment of persons with tuberculosis (TB). Since in-person directly observed treatment (DOT) can be resource intensive and challenging to implement, these technologies may have the potential to improve adherence and clinical outcomes. We reviewed the effect of these technologies on TB treatment adherence and patient outcomes.We searched several bibliographical databases for studies reporting the effect of digital interventions, including short message service (SMS), video-observed therapy (VOT) and medication monitors (MMs), to support treatment for active TB. Only studies with a control group and which reported effect estimates were included.Four trials showed no statistically significant effect on treatment completion when SMS was added to standard care. Two observational studies of VOT reported comparable treatment completion rates when compared with in-person DOT. MMs increased the probability of cure (RR 2.3, 95% CI 1.6-3.4) in one observational study, and one trial reported a statistically significant reduction in missed treatment doses relative to standard care (adjusted means ratio 0.58, 95% CI 0.42-0.79).Evidence of the effect of digital technologies to improve TB care remains limited. More studies of better quality are needed to determine how such technologies can enhance programme performance.

Copyright ©ERS 2018.

Figures

FIGURE 1
FIGURE 1
PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagram for selection of studies.

References

    1. Roine R, Ohinmaa A, Hailey D. Assessing telemedicine: a systematic review of the literature. CMAJ 2001; 165: 765–771.
    1. Goldfarb NM. Improving subject compliance with smart pill bottles. J Clin Res Best Pract 2007; 3: 1–5.
    1. Vervloet M, van Dijk L, Santen-Reestman J, et al. . SMS reminders improve adherence to oral medication in type 2 diabetes patients who are real time electronically monitored. Int J Med Inform 2012; 81: 594–604.
    1. Checchi KD, Huybrechts KF, Avorn J, et al. . Electronic medication packaging devices and medication adherence: a systematic review. JAMA 2014; 312: 1237–1247.
    1. Verhoeven F, Tanja-Dijkstra K, Nijland N, et al. . Asynchronous and synchronous teleconsultation for diabetes care: a systematic literature review. J Diabetes Sci Technol 2010; 4: 666–684.
    1. Verhoeven F, van Gemert-Pijnen L, Dijkstra K, et al. . The contribution of teleconsultation and videoconferencing to diabetes care: a systematic literature review. J Med Internet Res 2007; 9: e37.
    1. Krishna S, Boren SA. Diabetes self-management care via cell phone: a systematic review. J Diabetes Sci Technol 2008; 2: 509–517.
    1. Gentry S, van-Velthoven MH, Tudor Car L, et al. . Telephone delivered interventions for reducing morbidity and mortality in people with HIV infection. Cochrane Database Syst Rev 2013; 5: CD009189.
    1. Free C, Phillips G, Galli L, et al. . The effectiveness of mobile-health technology-based health behaviour change or disease management interventions for health care consumers: a systematic review. PLoS Med 2013; 10: e1001362.
    1. Vodopivec-Jamsek V, de Jongh T, Gurol-Urganci I, et al. . Mobile phone messaging for preventive health care. Cochrane Database Syst Rev 2012; 12: CD007459.
    1. Ambia J, Mandala J. A systematic review of interventions to improve prevention of mother-to-child HIV transmission service delivery and promote retention. J Int AIDS Soc 2016; 19: 20309.
    1. Castaño PM, Bynum JY, Andrés R, et al. . Effect of daily text messages on oral contraceptive continuation: a randomized controlled trial. Obstet Gynecol 2012; 119: 14–20.
    1. Lund S, Hemed M, Nielsen BB, et al. . Mobile phones as a health communication tool to improve skilled attendance at delivery in Zanzibar: a cluster-randomised controlled trial. BJOG 2012; 119: 1256–1264.
    1. World Health Organization. Global tuberculosis report 2016. Date last accessed: November 14, 2017.
    1. Karumbi J, Garner P. Directly observed therapy for treating tuberculosis. Cochrane Database Syst Rev 2015; 29: CD000343.
    1. World Health Organization. Digital health for the End TB Strategy: an agenda for action. Geneva, World Health Organisation, 2015. Date last accessed: November 14, 2017.
    1. World Health Organization. Towards TB elimination: an action framework for low-incidence countries: World Health Organization. Date last accessed: November 14, 2017.
    1. World Health Organization. Guidelines for treatment of drug-susceptible tuberculosis and patient care, 2017 update. Date last accessed: November 14, 2017.
    1. Falzon D, Timimi H, Kurosinski P, et al. . Digital health for the End TB Strategy: developing priority products and making them work. Eur Respir J 2016; 48: 29–45.
    1. Story A, Garfein RS, Hayward A, et al. . Monitoring therapy compliance of tuberculosis patients by using video-enabled electronic devices. Emerging Infect Dis 2016; 22: 538–540.
    1. Garfein R, Collins K, Munoz F, et al. . Feasibility of tuberculosis treatment monitoring by video directly observed therapy: a binational pilot study. Int J Tuberc Lung Dis 2015; 19: 1057–1064.
    1. Chuck C, Robinson E, Macaraig M, et al. . Enhancing management of tuberculosis treatment with video directly observed therapy in New York City. Int J Tuberc Lung Dis 2016; 20: 588–593.
    1. Wade VA, Karnon J, Eliott JA, et al. . Home videophones improve direct observation in tuberculosis treatment: a mixed methods evaluation. PLoS one 2012; 7: e50155.
    1. World Health Organization. Definitions and reporting framework for tuberculosis – 2013 revision. Date last accessed: November 14, 2017.
    1. Higgins JP, Green S. Cochrane handbook for systematic reviews of interventions. Hoboken, New Jersey, USA, John Wiley & Sons, 2011.
    1. Higgins JPT, Sterne JAC, Savović J, et al. . A revised tool for assessing risk of bias in randomized trials. In: Chandler J, McKenzie J, Boutron I, eds. Cochrane Methods. London, Cochrane Database of Systemic Reviews, 2016; Suppl. 1.
    1. Sterne J, Hernán MA, Reeves BC, et al. . ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ 2016; 355: i4919.
    1. Broomhead S, Mars M. Retrospective return on investment analysis of an electronic treatment adherence device piloted in the Northern Cape Province. Telemed J E Health 2012; 18: 24–31.
    1. Iribarren S, Beck S, Pearce PF, et al. . TextTB: A mixed method pilot study evaluating acceptance, feasibility, and exploring initial efficacy of a text messaging intervention to support TB treatment adherence. Tuberc Res Treat 2013; 2013: 12.
    1. Mohammed S, Glennerster R, Khan AJ. Impact of a daily SMS medication reminder system on tuberculosis treatment outcomes: a randomized controlled trial. PloS one 2016; 11: e0162944.
    1. Bediang G, Stoll B, Elia N, et al. . SMS reminders to improve tuberculosis cure in developing countries (TB-SMS Cameroon): a protocol of a randomised control study. Trials 2014; 15: 35 Date last accessed: December 15, 2017.
    1. Liu X, Lewis JJ, Zhang H, et al. . Effectiveness of electronic reminders to improve medication adherence in tuberculosis patients: a cluster-randomised trial. PLoS Med 2015; 12: e1001876.
    1. Hayward A, Garber E. TB Reach 5: to compare the efficacy of video observed treatment (VOT) versus directly observed treatment (DOT) in supporting adherence in patients with active tuberculosis. ISRCTN Reg 2014; .
    1. Sinkou H, Hurevich H, Rusovich V, et al. . Video-observed treatment for tuberculosis patients in Belarus: findings from the first programmatic experience. Eur Respir J 2017; 49: 1602049.
    1. Wald DS, Butt S, Bestwick JP. One-way versus two-way text messaging on improving medication adherence: meta-analysis of randomized trials. Am J Med 2015; 128: 1139.
    1. Mbuagbaw L, van der Kop ML, Lester RT, et al. . Mobile phone text messages for improving adherence to antiretroviral therapy (ART): an individual patient data meta-analysis of randomised trials. BMJ Open 2013; 3: e00395.
    1. Finitsis DJ, Pellowski JA, Johnson BT. Text message intervention designs to promote adherence to antiretroviral therapy (ART): a meta-analysis of randomized controlled trials. PloS one 2014; 9: e88166.
    1. Fang X-H, Guan S-Y, Tang L, et al. . Effect of short message service on management of pulmonary tuberculosis patients in Anhui Province, China: a prospective, randomized, controlled study. Med Sci Monit 2017; 23: 2465–2469.
    1. Self-verification and support via mobile phones drastically improves tuberculosis treatment success in LMIC settings. Date last updated: Aug 25, 2017. Date last accessed: November 14, 2017.
    1. Nglazi MD, Bekker L-G, Wood R, et al. . Mobile phone text messaging for promoting adherence to anti-tuberculosis treatment: a systematic review. BMC Infect Dis 2013; 13: 566.
    1. Virtually observed treatment (VOT) for tuberculosis patients in Moldova. Date last updated: September 25, 2015. Date last accessed: November 14, 2017.
    1. Liu X. A trial of an electronic pill box with reminders for patients taking treatment for tuberculosis ISRCTN Reg 2016; .
    1. An evaluation of traditional directly observed therapy (DOT) and electronic DOT for TB treatment. Date last updated: August 29, 2017. Date last accessed: November 14, 2017.
    1. Mehta U, Durrheim DN, Blockman M, et al. . Adverse drug reactions in adult medical inpatients in a South African hospital serving a community with a high HIV/AIDS prevalence: prospective observational study. Br J Clin Pharmacol 2008; 65: 396–406.

Source: PubMed

スポンサーと協力者

医学的状態

薬物療法

3
購読する