Effect of a phone reminder system on patient-centered tuberculosis treatment adherence among adults in Northwest Ethiopia: a randomised controlled trial

Abstract

ObjectivesThis 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.MethodsWe 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.ResultsWe 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.ConclusionsMobile 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 numberPan African Clinical Trials Registry (PACTR201901552202539).

Evaluation of implementation and effectiveness of digital adherence technology with differentiated care to support tuberculosis treatment adherence and improve treatment outcomes in Ethiopia: a study protocol for a cluster randomised trial

“…Findings from trials in Pakistan, China and Cameroon suggested that text messaging reminders have neither improved medication adherence [ 21 , 22 ] nor did they increase treatment success and cure proportions [ 18 ]. A trial in Ethiopia found mobile phone-based weekly refilling with daily medication reminder system improved medication adherence but with no significant effect on treatment success [ 23 ]. However, another trial from China indicated that text messaging positively impacted treatment completion rate and negatively influenced missed dose rate and interrupted treatment rate [ 20 ] and a trial conducted in Kenya assessing a text messaging intervention demonstrated a reduction in unsuccessful treatment outcome, mainly though reducing loss to follow-up [ 24 ].…”

Increasing Self Efficacy Behavior Prevention of Transmission and Compliance with Tuberculosis Medication through Health Promotion: A Systematic Review

“…English Science Direct Conventional health promotion (Bisallah et al, 2018;Gashu et al, 2021;Kerr et al, 2020;Spruijt et al, 2020;Tola et al, 2016;Zare et al, 2017).…”

Mobile application development for improving medication safety in tuberculosis patients: A quasi-experimental study protocol

“…Studies suggest adherence interventions for improving outcomes, such as medication event reminder monitor (MERM) systems, electronic pillboxes, and text messaging [ 10 , 11 ]. Medication reminders appear to improve compliance and staff-patient relationships, but have not been shown to cause significant differences in treatment success [ 12 ].…”