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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.


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.

SUBMITTER: de Groot LM 

PROVIDER: S-EPMC9145978 | biostudies-literature | 2022 Apr

REPOSITORIES: biostudies-literature

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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.

de Groot Liza M LM   Straetemans Masja M   Maraba Noriah N   Jennings Lauren L   Gler Maria Tarcela MT   Marcelo Danaida D   Mekoro Mirchaye M   Steenkamp Pieter P   Gavioli Riccardo R   Spaulding Anne A   Prophete Edwin E   Bury Margarette M   Banu Sayera S   Sultana Sonia S   Onjare Baraka B   Efo Egwuma E   Alacapa Jason J   Levy Jens J   Morales Mona Lisa L MLL   Katamba Achilles A   Bogdanov Aleksey A   Gamazina Kateryna K   Kumarkul Dzhumagulova D   Ekaterina Orechova-Li OL   Cattamanchi Adithya A   Khan Amera A   Bakker Mirjam I MI  

Tropical medicine and infectious disease 20220422 5


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,  ...[more]

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