Digital monitoring technologies could enhance tuberculosis medication adherence in Uganda: Mixed methods study
Digital monitoring technologies could enhance tuberculosis medication adherence in Uganda: Mixed methods study
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DOI：
10.1016/j.jctube.2019.100119
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发表时间：
2019-12-01
影响因子：
2
通讯作者：
Haberer, Jessica E.
中科院分区：
文献类型：
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作者：
Musiimenta, Angella;Tumuhimbise, Wilson;Haberer, Jessica E.
背景：有效实施结核病治疗仍然具有挑战性。推荐的直接观察治疗策略具有挑战性，并且其实施在许多情况下受到限制。数字依从性技术可能是有前景的以患者为中心的依从性监测策略。然而，很少有高质量的研究评估患者使用这些技术的体验。目的：探讨结核病患者对由数字依从性监测器和短信组成的数字依从性干预的看法。方法：我们有目的地对拥有手机、已服用结核病药物至少一个月并正在姆巴拉拉地区转诊医院接受治疗的结核病患者进行抽样。我们采访了 35 名结核病患者，以了解对拟议干预措施的看法，该干预措施以电子方式监控他们如何服药，并向患者发送短信提醒以帮助他们服药，并向患者的社会支持者发送短信通知，以便在可能的情况下为患者提供帮助。我们使用内容分析对数据进行归纳分析，得出描述参与者如何看待干预措施的类别。结果：参与者预期干预措施将通过提醒他们服药并帮助管理复杂的治疗方案来提高药物依从性。参与者认为，监测遵守情况可以使他们展示他们对遵守情况的承诺。参与者对未按时看到短信和无意的结核病状况披露表示担忧。结论：数字依从性技术可能为监测结核病药物提供可接受的替代方法，特别是在 DOT 难以实施的环境中。
Background: Effective administration of tuberculosis therapy remains challenging. The recommended strategy of direct observed therapy is challenging and its implementation has been limited in many settings. Digital adherence technologies could be promising patient-centered strategies for monitoring adherence. However, few quality studies have assessed patients' experiences with these technologies.Objective: To explore TB patients' perceptions of a digital adherence intervention composed of a digital adherence monitor and SMS texts.Methods: We purposively sampled TB patients who owned phones, had been taking TB medication for at least a month, and were receiving their treatment from Mbarara Regional Referral Hospital. We interviewed 35 TB patients to elicit information on perceptions of the proposed intervention which electronically monitors how they take their medication, and sends SMS reminders to patients to help them take their medications, as well as send SMS notifications to patients' social supporters to provide the patient with assistance if possible. We inductively analyzed data using content analysis to derive categories describing how participants perceived the intervention.Results: Participants anticipated that the intervention would enhance medication adherence by reminding them to take medication, and helping in the management of complicated regimen. Participants felt that monitoring adherence could enable them to demonstrate their commitment to adherence. Participants expressed concerns about not seeing the SMS on time and unintended TB status disclosure.Conclusion: Digital adherence technologies may provide acceptable alternative approaches to monitoring TB medication, especially in settings where DOT is difficult to implement.