The impact of digital health technologies on tuberculosis treatment: A systematic review

Brian Kermu Ngwatu, Ntwali Placide Nsengiyumva, Olivia Oxlade, Benjamin Mappin-Kasirer, Nhat Linh Nguyen, Ernesto Jaramillo, Dennis Falzon, Kevin Schwartzman, I. Abubakar, N. Alipanah, M. Bastos, D. Boccia, D. Chin, T. Cohen, J. L. Davis, C. Denkinger, D. Falzon, K. Fielding, C. Free, G. FoxR. S. Garfein, A. Hayward, E. Jaramillo, R. Lester, J. Lewis, B. Mappin-Kasirer, F. Marx, D. Menzies, G. B. Migliori, P. Nahid, B. Ngwatu, N. P. Nsengiyumva, N. L. Nguyen, O. Oxlade, K. Schwartzman, K. Siddiqi, A. Story, B. Thomas, A. Trajman, M. Yassin

Research output: Contribution to journalReview articlepeer-review

48 Citations (Scopus)

Abstract

Digital technologies are increasingly harnessed to support treatment of persons with tuberculosis (TB). Since in-person directly observed treatment (DOT) can be resource intensive and challenging to implement, these technologies may have the potential to improve adherence and clinical outcomes. We reviewed the effect of these technologies on TB treatment adherence and patient outcomes. We searched several bibliographical databases for studies reporting the effect of digital interventions, including short message service (SMS), video-observed therapy (VOT) and medication monitors (MMs), to support treatment for active TB. Only studies with a control group and which reported effect estimates were included. Four trials showed no statistically significant effect on treatment completion when SMS was added to standard care. Two observational studies of VOT reported comparable treatment completion rates when compared with in-person DOT. MMs increased the probability of cure (RR 2.3, 95% CI 1.6-3.4) in one observational study, and one trial reported a statistically significant reduction in missed treatment doses relative to standard care (adjusted means ratio 0.58, 95% CI 0.42-0.79). Evidence of the effect of digital technologies to improve TB care remains limited. More studies of better quality are needed to determine how such technologies can enhance programme performance.

Original languageEnglish
Article number1701596
JournalEuropean Respiratory Journal
Volume51
Issue number1
DOIs
Publication statusPublished - 2018
Externally publishedYes

Bibliographical note

Funding Information:
This work was funded by the European Respiratory Society, via the World Health Organization Stop TB Programme. Funding information for this article has been deposited in the Crossref Funder Registry

Funding Information:
Support statement: This work was funded by the European Respiratory Society, via the World Health Organization Stop TB Programme. Funding information for this article has been deposited in the Crossref Funder Registry

Publisher Copyright:
Copyright © ERS 2018.

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