SynthesisBMJ global health2024
The performance of digital technologies for measuring tuberculosis medication adherence: a systematic review.
Synthesis in BMJ global health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The impact of digital adherence technologies on treatment outcomes, adherence, and patient-reported outcomes in tuberculosis: a systematic review and meta-analysis.BMC infectious diseases · 2025Pooled it
- The Acceptability of a Real-Time Medication Monitoring-Based Digital Adherence Tool Among Young People Living with HIV in Malawi.AIDS and behavior · 2026Trial
- Baseline determinants of adherence for drug-sensitive TB treatment in a South African prospective cohort: a focus on HIV infection and anti-retroviral therapy, clinical care access, and TB stigma.BMC infectious diseases · 2026Trial
- Trial
- Trial
- User engagement in the tuberculosis treatment support tools intervention and its impact on treatment outcomes: A secondary analysis of a pragmatic trial.PLOS digital health · 2026Article
- A qualitative study of home- versus facility-based TB treatment for adolescents in Lima, Peru.Public health action · 2025Article
- Effects of missed anti-tuberculosis therapy doses on treatment outcome: a multi-center cohort study.Lancet regional health. Americas · 2025Article
- User-Centered Refinement of a Digital Tool for Tuberculosis Treatment Support: Iterative Mixed Methods Study.Journal of medical Internet research · 2025Article
- 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
- Implementation outcomes of tuberculosis digital adherence technologies: a scoping review using the RE-AIM framework.BMJ global health · 2025Article
- Contextual factors influencing implementation of tuberculosis digital adherence technologies: a scoping review guided by the RE-AIM framework.BMJ global health · 2025Article
- Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionDigital adherence technologies (DATs), such as phone-based technologies and digital pillboxes, can provide more person-centric approaches to support tuberculosis (TB) treatment. However, there are varying estimates of their performance for measuring medication adherence.
methodsWe conducted a systematic review (PROSPERO-CRD42022313526), which identified relevant published literature and preprints from January 2000 to April 2023 in five databases. Studies reporting quantitative data on the performance of DATs for measuring TB medication adherence against a reference standard, with at least 20 participants, were included. Study characteristics and performance outcomes (eg, sensitivity, specificity and predictive values) were extracted. Sensitivity was the proportion correctly classified as adherent by the DAT, among persons deemed adherent by a reference standard. Specificity was the proportion correctly classified as non-adherent by the DAT, among those deemed non-adherent by a reference standard.
resultsOf 5692 studies identified by our systematic search, 13 met inclusion criteria. These studies investigated medication sleeves with phone calls (branded as '99DOTS'; N=4), digital pillboxes N=5), ingestible sensors (N=2), artificial intelligence-based video-observed therapy (N=1) and multifunctional mobile applications (N=1). All but one involved persons with TB disease. For medication sleeves with phone calls, compared with urine testing, reported sensitivity and specificity were 70%-94% and 0%-61%, respectively. For digital pillboxes, compared with pill counts, reported sensitivity and specificity were 25%-99% and 69%-100%, respectively. For ingestible sensors, the sensitivity of dose detection was ≥95% compared with direct observation. Participant selection was the most frequent potential source of bias.
conclusionThe limited number of studies available suggests suboptimal and variable performance of DATs for dose monitoring, with significant evidence gaps, notably in real-world programmatic settings. Future research should aim to improve understanding of the relationships of specific technologies, settings and user engagement with DAT performance and should measure and report performance in a more standardised manner.
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