ArticleBMJ open2023
Qualitative study exploring the feasibility of using medication monitors and a differentiated care approach to support adherence among people receiving TB treatment in South Africa.
Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 18 citations in OpenAlex.
- Feasibility and acceptability of the smart pillbox and medication label with differentiated care to support person-centered tuberculosis care among ASCENT trial participants - A multicountry study.Frontiers in public health · 2024Trial
- Real-time electronic drug monitoring: experiences from a multinational phase 3 clinical trial to prevent multidrug-resistant TB.IJTLD open · 2026Article
- Enhancing tuberculosis care in lower and middle-income countries through digital adherence technologies.Breathe (Sheffield, England) · 2026Article
- Engagement With Digital Adherence Technologies as Measures of Intervention Fidelity Among Adults With Drug-Susceptible Tuberculosis and Health Care Providers: Descriptive Analysis Using Data From Cluster-Randomized Trials in Five Countries.JMIR public health and surveillance · 2025Article
- Process Evaluation of Pragmatic Cluster-Randomized Trials of Digital Adherence Technologies for Tuberculosis Treatment Support: A Mixed-Method Study in Five Countries.Tropical medicine and infectious disease · 2025Article
- The behaviour of TB patients in East Lombok through a health belief model approach.Journal of health, population, and nutrition · 2025Article
- Acceptability of Digital Adherence Technologies to support people with drug-susceptible TB in South Africa.PloS one · 2025Article
- The burden of tuberculosis and drug resistance in 22 Sub-Saharan African countries, 1990-2021: a GBD 2021 analysis and progress towards WHO 2035 targets with projections to 2050.Frontiers in microbiology · 2025Article
- Article
- Differentiated service delivery framework for people with multidrug-resistant tuberculosis and HIV co-infection.Journal of acquired immune deficiency syndromes (1999) · 2024Article
- Implementation bottlenecks of real time medication monitoring (evriMED) for improving adherence to anti-TB drugs among people with tuberculosis in Kilimanjaro, Tanzania.Journal of clinical tuberculosis and other mycobacterial diseases · 2024Article
- Factors related to the utilization of digital adherence technologies in tuberculosis care: A qualitative study among adults in DS-TB treatment, health care providers and other key actors in Tanzania.PLOS global public health · 2024Article
Corrections and comments
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Authors and funding
10 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe tuberculosis (TB) MATE study evaluated whether a differentiated care approach (DCA) based on tablet-taking data from Wisepill evriMED digital adherence technology could improve TB treatment adherence. The DCA entailed a stepwise increase in adherence support starting from short message service (SMS) to phone calls, followed by home visits and motivational counselling. We explored feasibility of this approach with providers in implementing clinics.
designBetween June 2020 and February 2021, in-depth interviews were conducted in the provider's preferred language, audiorecorded, transcribed verbatim and translated. The interview guide included three categories: feasibility, system-level challenges and sustainability of the intervention. We assessed saturation and used thematic analysis.
settingPrimary healthcare clinics in three provinces of South Africa.
participantsWe conducted 25 interviews with 18 staff and 7 stakeholders.
resultsThree major themes emerged: First, providers were supportive of the intervention being integrated into the TB programme and were eager to be trained on the device as it helped to monitor treatment adherence. Second, there were challenges in the adoption system such as shortage of human resources which could serve as a barrier to information provision once the intervention is scaled up. Healthcare workers reported that some patients received incorrect SMS's due to delays in the system that contributed to distrust. Third, DCA was considered as a key aspect of the intervention by some staff and stakeholders since it allowed for support based on individual needs.
conclusionsIt was feasible to monitor TB treatment adherence using the evriMED device and DCA. To ensure successful scale-up of the adherence support system, emphasis will need to be placed on ensuring that the device and the network operate optimally and continued support on adhering to treatment which will enable people with TB to take ownership of their treatment journey and help overcome TB-related stigma. TRIAL REGISTRATION NUMBER: Pan African Trial Registry PACTR201902681157721.
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