Electronic Reminders Help TB Patients Stay On Track

Electronic reminders could help China deal with the growing problem of TB by improving patient adherence.

AsianScientist (Sep. 25, 2015) – Giving electronic reminders to tuberculosis (TB) patients in China can reduce the amount of medication doses they miss by half, according to new research published in PLOS Medicine.

Researchers from the London School of Hygiene & Tropical Medicine and China’s National Center for Tuberculosis Control and Prevention conducted a trial with 4,173 patients from the provinces of Heilongjiang, Jiangsu, Hunan, and Chongqing. Patients either received text message reminders, an electronic medication monitor, both, or no reminders for their six month treatment period.

Patients receiving no reminders missed taking 29.9 percent of their medication doses and patients receiving text messages missed 27.3 percent of their doses. However, patients with an electronic medication monitor box—which beeped if not opened at the agreed time—only missed 17 percent of their medication doses. Patients who received both text messages and an electronic medication monitor missed just 13.9 percent of medication doses.

According to the World Health Organization, China has the world’s second largest number of TB cases, accounting for 11 percent of the estimated nine million global cases.

TB treatment usually lasts for six months and is effective if taken fully, but patients missing drug treatment doses is a major problem. This increases the risk of having a relapse of TB and also TB becoming drug resistant, making the disease more difficult to treat and potentially fatal.

Senior author Dr. Katherine Fielding of the London School of Hygiene & Tropical Medicine, said: “Global plans to reduce TB advise that treatment be taken under the direct observation of a healthcare worker to reduce missed doses, something which has been difficult to carry out in many parts of China, particularly in rural areas, as in other parts of world. Innovative approaches are needed to tackle this problem.”

Project investigator Dr. Jiang Shiwen of the National Center for Tuberculosis Control and Prevention, added: “Directly observed therapy is difficult to implement in China due to limited human resources, poor acceptance and other factors. We are currently planning a further evaluation of a management model including the use the medication monitor on long-term TB outcomes including TB recurrence. China plans to scale up the use of medication monitors in some provinces in the next five years.”

The authors note their findings may have been limited due to battery problems with the medication monitor, leading to loss of data for some patients.

The article can be found at: Liu et al. (2015) Effectiveness of Electronic Reminders to Improve Medication Adherence in Tuberculosis Patients: A Cluster-Randomized Trial.

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Source: London School of Hygiene & Tropical Medicine; Photo: Dvortygirl/Flickr/CC.
Disclaimer: This article does not necessarily reflect the views of AsianScientist or its staff.

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