Gashu KD, Gelaye KA, Lester R, Tilahun B. Effect of a phone reminder system on patient-centered tuberculosis treatment adherence among adults in Northwest Ethiopia: a randomised controlled trial.
BMJ Health Care Inform 2021;
28:e100268. [PMID:
34172505 PMCID:
PMC8237748 DOI:
10.1136/bmjhci-2020-100268]
[Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 05/20/2021] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES
This study aimed to evaluate the effect of the phone reminder system on patient-centred TB treatment adherence during continuation phase, where patients are responsible for taking medication at home.
METHODS
We conducted a two-arm randomised controlled trial on adult patients with TB during the continuation phase. In the intervention arm, patients received routine care plus phone-based weekly pill refilling and daily medication reminders. In the control arm, participants received only routine care. A covariate adaptive randomisation technique was used to balance covariates during allocation. The primary outcome was adherence to patient-centred TB treatment, and secondary outcomes included provider-patient relationship and treatment outcomes. We applied per-protocol and intention-to-treat analysis techniques.
RESULTS
We randomised 306 patients to intervention (n=152) and control (n=154) groups. Adherence to patient-centred TB treatment was 79% (110/139) in intervention and 66.4% (95/143) in control groups, with relative risk (RR) (95% lower CI) (RR=1.632 (1.162 to ∞); p=0.018, one tailed). Good provider-patient relationship was 73.3% (102/139) in intervention group and 52.4% (75/143) in control group, p=0.0001. TB treatment success was 89.5% (136/152) in intervention group and 85.1% (131/154) in control group, p=0.1238.
CONCLUSIONS
Mobile phone-based weekly refilling with daily medication reminder system improved adherence to patient-centred TB treatment and provider-patient relationship; however, there was no significant effect on treatment success.
TRIAL REGISTRATION NUMBER
Pan African Clinical Trials Registry (PACTR201901552202539).
Collapse