Effectiveness of Digital Health Interventions to Enhance Continuity of Care in Patients with Pulmonary Tuberculosis: A Systematic Review of Randomized Controlled Trials.

IF 2 3区医学 Q2 MEDICINE, GENERAL & INTERNAL

Patient preference and adherence Pub Date : 2025-06-23 eCollection Date: 2025-01-01 DOI:10.2147/PPA.S533210

Qonita Nur Miladi, Tuti Pahria, Iqbal Pramukti

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引用次数: 0

Abstract

Background: Pulmonary tuberculosis (TB) remains a global health concern with high morbidity and mortality rates. Despite being curable with proper treatment, challenges in ensuring continuity of care persist, particularly in resource-limited settings. Digital health interventions (DHI) offer a potential solution to improve treatment adherence and continuity of care among TB patients.

Purpose: This study aimed to systematically review how DHIs contribute to improved continuity of care, particularly in terms of medication adherence, clinical outcomes, and patient satisfaction.

Methods: A systematic review was conducted using PRISMA guidelines. Relevant studies were identified from five significant databases, including PubMed, Scopus, Taylor and Francis, EBSCO-host, and ScienceDirect, up to November 2024 and one search engine was Google Scholar. The keywords used were "pulmonary tuberculosis OR tbc OR tb AND mobile health applications OR mhealth OR mobile apps OR telehealth AND continuity of care OR patient compliance OR patient adherence OR adherence behaviour. Inclusion criteria focused on RCTs evaluating DHIs for adult TB patients. Data were extracted and analyzed thematically to assess intervention effectiveness on medication adherence and clinical outcomes.

Results: A total of 17.380 patients from 21 studies TB patients were included. Interventions were classified into two categories: reminder-based (eg, SMS, phone calls, electronic medicine boxes with audio/visual alerts) and remote monitoring-based (eg, MERM, mobile applications, digital sensors, and VDOT). Compared to standard care, DHIs significantly improved medication adherence, treatment success rates, and patient satisfaction. Several studies also reported reduced time and cost burdens for patients.

Conclusion: DHIs improve continuity of care among TB patients by increasing medication adherence and clinical outcomes. However, the effectiveness varies across different intervention types and settings, emphasizing the need for tailored strategies and integration into existing health systems.

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数字健康干预提高肺结核患者护理连续性的有效性：随机对照试验的系统评价

背景：肺结核（TB）仍然是一个全球性的健康问题，发病率和死亡率都很高。尽管通过适当治疗可以治愈，但在确保护理连续性方面仍然存在挑战，特别是在资源有限的环境中。数字卫生干预措施（DHI）为改善结核病患者的治疗依从性和护理连续性提供了一种潜在的解决方案。目的：本研究旨在系统地回顾DHIs如何有助于改善护理的连续性，特别是在药物依从性、临床结果和患者满意度方面。方法：采用PRISMA指南进行系统评价。相关研究从PubMed、Scopus、Taylor and Francis、EBSCO-host、ScienceDirect等5个截止到2024年11月的重要数据库和b谷歌Scholar搜索引擎中检索。使用的关键词是“肺结核或tbc或tb和移动医疗应用程序或移动医疗应用程序或远程医疗和护理连续性或患者依从性或患者依从性或依从性行为。纳入标准侧重于评估成年结核病患者DHIs的随机对照试验。提取数据并进行主题分析，以评估干预对药物依从性和临床结果的有效性。结果：共纳入21项研究的17380例TB患者。干预措施分为两类：基于提醒的（如短信、电话、带有音频/视觉警报的电子药箱）和基于远程监控的（如MERM、移动应用程序、数字传感器和VDOT）。与标准治疗相比，DHIs显著提高了药物依从性、治疗成功率和患者满意度。几项研究也报告了减少患者的时间和费用负担。结论：DHIs通过增加药物依从性和临床结果改善了结核病患者护理的连续性。然而，在不同的干预类型和环境中，效果有所不同，这强调需要制定量身定制的战略并将其纳入现有卫生系统。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Patient preference and adherence MEDICINE, GENERAL & INTERNAL-

CiteScore

3.60

自引率

4.50%

发文量

354

审稿时长

6-12 weeks

期刊介绍： Patient Preference and Adherence is an international, peer reviewed, open access journal that focuses on the growing importance of patient preference and adherence throughout the therapeutic continuum. The journal is characterized by the rapid reporting of reviews, original research, modeling and clinical studies across all therapeutic areas. Patient satisfaction, acceptability, quality of life, compliance, persistence and their role in developing new therapeutic modalities and compounds to optimize clinical outcomes for existing disease states are major areas of interest for the journal. As of 1st April 2019, Patient Preference and Adherence will no longer consider meta-analyses for publication.