Formative acceptance of ingestible biosensors to measure adherence to TB medications.

Autor: Vaz C; Department of Emergency Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02114, USA.; Department of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, MA, USA., Jose NK; Division of Non-Communicable Diseases, Indian Council of Medical Research, HQs, New Delhi, India., Tom JJ; Department of Gastroenterology, Amala Institute of Medical Sciences, Thrissur, Kerala, India., Goodman GR; Department of Emergency Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02114, USA.; The Fenway Institute, Fenway Health, Boston, MA, USA.; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA., Lee JS; The Fenway Institute, Fenway Health, Boston, MA, USA.; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA., Padappayil RP; Department of Internal Medicine, Monmouth Medical Center, Long Branch, NJ, USA., Madathil M; Department of Dermatology, Amala Institute of Medical Sciences, Thrissur, Kerala, India.; Department of Dermatology, Imbichibava Memorial Co-Operative Hospital and Research Center, Malappuram, Kerala, India., O'Cleirigh C; The Fenway Institute, Fenway Health, Boston, MA, USA.; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA., Rodrigues R; Department of Community Health, St. John's Medical College, St. John's Research Institute, Bangalore, India., Chai PR; Department of Emergency Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02114, USA. pchai@bwh.harvard.edu.; Department of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, MA, USA. pchai@bwh.harvard.edu.; The Fenway Institute, Fenway Health, Boston, MA, USA. pchai@bwh.harvard.edu.; Koch Institute for Integrated Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA. pchai@bwh.harvard.edu.
Jazyk: angličtina
Zdroj: BMC infectious diseases [BMC Infect Dis] 2022 Sep 28; Vol. 22 (1), pp. 754. Date of Electronic Publication: 2022 Sep 28.
DOI: 10.1186/s12879-022-07756-x
Abstrakt: Background: Tuberculosis (TB) represents a significant public health threat in India. Adherence to antitubercular therapy (ATT) is the key to reducing the burden of this infectious disease. Suboptimal adherence to ATT and lack of demonstrated feasibility of current strategies for monitoring ATT adherence highlights the need for alternative adherence monitoring systems.
Methods: A quantitative survey was conducted to assess the acceptance of and willingness to use a digital pill system (DPS) as a tool for monitoring ATT adherence among stakeholders directly involved in the management of patients with TB in India. Participants reviewed a video explaining the DPS and completed a survey, which covered sociodemographics, degree of involvement with TB patients, initial impressions of the DPS, and perceived challenges for deploying the technology in India. Participants were also asked to interpret mock DPS adherence data.
Results: The mean age was 34.3 (SD = 7.3), and participants (N = 50) were predominantly male (70%). The sample comprised internists (52%) and pulmonologists (30%), with a median of 4 years' experience (IQR 3, 6) in the management of TB patients. No participants had previously used a DPS, but some reported prior awareness of the technology (22%). Most reported that they would recommend use of a DPS to patients on ATT (76%), and that they would use a DPS in both the intensive and continuation phases of TB management (64%). The majority viewed the DPS (82%) as a useful alternative to directly observed therapy-short course (DOTS), particularly given the ongoing COVID-19 pandemic. Participants reported that a DPS would be most effective in patients at risk of nonadherence (64%), as well as those with past nonadherence (64%). Perceived barriers to DPS implementation included lack of patient willingness (92%), cost (86%), and infrastructure constraints (66%). The majority of participants were able to accurately interpret patterns of adherence (80%), suboptimal adherence (90%), and frank nonadherence (82%) when provided with mock DPS data.
Conclusions: DPS are viewed as an acceptable, feasible, and useful technology for monitoring ATT adherence by stakeholders directly involved in TB management. Future investigations should explore patient acceptance of DPS and pilot demonstration of the system in the TB context.
(© 2022. The Author(s).)
Databáze: MEDLINE
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