AUTHOR=Zhang Mengxian , Wang Guiyang , Najmi Hina , Yaqoob Aashifa , Li Tao , Xia Yinyin , Ye Jianjun , Hou Shuangyi , Xiao Ye , Zhou Liping , Li Yuehua 

TITLE=Digitizing tuberculosis treatment monitoring in Wuhan city, China, 2020–2021: Impact on medication adherence

JOURNAL=Frontiers in Public Health

VOLUME=Volume 11 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1033532

DOI=10.3389/fpubh.2023.1033532

ISSN=2296-2565

ABSTRACT=Digital technologies can improve adherence to tuberculosis (TB) treatment. We studied the impact of digitizing TB treatment monitoring on adherence among TB patients in Wuhan, China, during 2020-2021. We compared an electronic system introduced to monitor TB medication adherence (e-Patient Service System; e-PSS) with the paper-based standard of care (TB Control Information System; TCIS) in terms of prescribed TB treatment doses taken by patients and patient outcome after six months of follow-up. We designed a cross-sectional study using retrospective data for all drug-susceptible pulmonary TB patients recorded on both systems. The main indicators were: compliant first follow-up visit (within 3 days of start of treatment); medication adherence (80% or more of monthly doses taken); and end-of-treatment success ratio. A total of 1,576 TB patients were recorded in TCIS in July-September, 2020 and 1,145 TB cases were included in e-PSS in January-March, 2021. The distribution of patient demographic and clinical features was similar between the two groups. A larger proportion from the e-PSS group visited the community doctor in the first three days compared with the TCIS group (48.91% versus 29.76% respectively). Medication adherence was also higher in the e-PSS group during the 6 months of treatment than in the TCIS group (84.28% versus 80.33% respectively). Treatment success was 92.52% in the e-PSS group and 92.07% in the TCIS group. Multivariate logistic regression analysis demonstrated that adjusted odds ratios for compliant first follow-up visit, medication adherence and favorable treatment outcome in the e-PSS versus TCIS groups were 2.94 (95%CL: 2.47-3.50), 1.33 (95%CL: 1.08-1.63) and 1.12 (95%CL: 0.79-1.57) respectively. This study revealed improvements in TB care following an intervention to monitor treatment digitally in patients in Wuhan, China.