Time Trend Analysis of Tuberculosis Treatment While Using Digital Adherence Technologies—An Individual Patient Data Meta-Analysis of Eleven Projects across Ten High Tuberculosis-Burden Countries
Loading...
Date
2022
Journal Title
Journal ISSN
Volume Title
Publisher
Tropical Medicine and Infectious Disease
Abstract
Worldwide, non-adherence to tuberculosis (TB) treatment is problematic. Digital adherence
technologies (DATs) offer a person-centered approach to support and monitor treatment. We explored
adherence over time while using DATs. We conducted a meta-analysis on anonymized longitudinal
adherence data for drug-susceptible (DS) TB (n = 4515) and drug-resistant (DR) TB (n = 473) populations
from 11 DAT projects. Using Tobit regression, we assessed adherence for six months of
treatment across sex, age, project enrolment phase, DAT-type, health care facility (HCF), and project.
We found that DATs recorded high levels of adherence throughout treatment: 80% to 71% of DS-TB
patients had 90% adherence in month 1 and 6, respectively, and 73% to 75% for DR-TB patients. Adherence
increased between month 1 and 2 (DS-TB and DR-TB populations), then decreased (DS-TB).
Males displayed lower adherence and steeper decreases than females (DS-TB). DS-TB patients aged
15–34 years compared to those >50 years displayed steeper decreases. Adherence was correlated
within HCFs and differed between projects. TB treatment adherence decreased over time and differed
between subgroups, suggesting that over time, some patients are at risk for non-adherence. The
real-time monitoring of medication adherence using DATs provides opportunities for health care
workers to identify patients who need greater levels of adherence support.
Description
Keywords
Tuberculosis, Digital adherence technologies, Meta-analyses, Implementation research, Multi-country, Medication adherence, Mobile technologies
Citation
de Groot, L.M.; Straetemans, M.; Maraba, N.; Jennings, L.; Gler, M.T.; Marcelo, D.; Mekoro, M.; Steenkamp, P.; Gavioli, R.; Spaulding, A.; et al. Time Trend Analysis of Tuberculosis Treatment While Using Digital Adherence Technologies—An Individual Patient Data Meta-Analysis of Eleven Projects across Ten High Tuberculosis- Burden Countries. Trop. Med. Infect. Dis. 2022, 7, 65. https://doi.org/ 10.3390/tropicalmed7050065