Evidence map›Paper›PMID 39042889›Full record

ArticleJMIR human factors2024

Digital Adherence Technologies and Differentiated Care for Tuberculosis Treatment and Their Acceptability Among Persons With Tuberculosis, Health Care Workers, and Key Informants in the Philippines: Qualitative Interview Study.

Chung Lam Leung, Jason Alacapa, Bianca Gonçalves Tasca, Andre Daniel Villanueva, Saniata Masulit, Marvin Louie Ignacio, Kathleen Nicole Uy, Christopher Pell, Kristian van Kalmthout, Rachel Powers and 2 more

Abstract read
In one paragraph

Article in JMIR human factors, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Chung Lam LeungKNCV Tuberculosis Foundation, Den Haag, Netherlands.ORCID 0009-0000-5563-1502
Jason AlacapaKNCV Tuberculosis Foundation Philippines, Metro Manila, Philippines.ORCID 0000-0002-0794-3947
Bianca Gonçalves TascaKNCV Tuberculosis Foundation, Den Haag, Netherlands.ORCID 0000-0002-0737-8052
Andre Daniel VillanuevaKNCV Tuberculosis Foundation Philippines, Metro Manila, Philippines.ORCID 0009-0003-5486-6248
Saniata MasulitKNCV Tuberculosis Foundation Philippines, Metro Manila, Philippines.ORCID 0009-0003-4356-2767
Marvin Louie IgnacioKNCV Tuberculosis Foundation Philippines, Metro Manila, Philippines.ORCID 0000-0003-1665-3156
Kathleen Nicole UyKNCV Tuberculosis Foundation Philippines, Metro Manila, Philippines.ORCID 0009-0006-8058-6962
Christopher PellKNCV Tuberculosis Foundation, Den Haag, Netherlands.ORCID 0000-0001-9405-5851
Kristian van KalmthoutKNCV Tuberculosis Foundation, Den Haag, Netherlands.ORCID 0009-0007-2526-1708
Rachel PowersKNCV Tuberculosis Foundation, Den Haag, Netherlands.ORCID 0009-0003-5930-7162
Katherine FieldingTB Centre and Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.ORCID 0000-0002-6524-3754
Degu JereneKNCV Tuberculosis Foundation, Den Haag, Netherlands.ORCID 0000-0001-7853-4211

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDigital adherence technologies (DATs) are being studied to determine their potential to support tuberculosis (TB) treatment and address the shortcomings of directly observed therapy. Previous research has shown inconclusive results on whether DATs can enhance medication adherence among persons with TB.

objectiveThis study aims to understand the acceptability of DATs, namely, medication labels and smart pillboxes, among persons with TB, health care workers (HCWs), and key informants (KIs) in the Philippines. The objective is to gain valuable insights that can inform the design and implementation of DATs in the Southeast Asian region, which meet the needs and preferences of end users.

methodsPersons with TB, HCWs, and KIs were recruited from intervention facilities to participate in in-depth interviews conducted between March 2022 and January 2023. These interviews were transcribed and translated into English. A thematic analysis was carried out using NVivo software (Lumivero) to identify and analyze themes. Themes were then structured within a modified social-ecological model.

resultsA total of 25 persons with drug-sensitive TB and 20 HCWs or KIs were interviewed. Both groups emphasized that users' technology literacy level, financial conditions, and motivation to be cured determined how they interacted with the DAT. They also acknowledged that DATs helped foster their relationship with HCWs and enabled efficient treatment support. Concerning technology, persons with TB found DATs easy to use and able to reduce clinic visits. HCWs mentioned that DATs added to their workload but also allowed them to support users who missed doses. However, both groups experienced technical challenges with DATs. Regarding program implementation, users appreciated the clear explanations and demonstrations provided by HCWs. Yet, some users reported inconsistencies between DAT settings and the information provided. HCWs stressed the importance of comprehensive training and sufficient resources for effective program implementation in the future. At the community level, both groups noted that DATs and program design protected users' privacy and reduced the risk of stigma. Finally, users and HCWs shared various contextual factors that influenced their experience with DAT, including infrastructure challenges and the impact of the COVID-19 pandemic.

conclusionsIn the Philippines, persons with TB and HCWs showed a high level of acceptance and satisfaction with the impact of DAT and program design. They expressed a desire for the continuation of DATs. The challenges encountered underscore the need for ongoing technological development to minimize malfunctions, enhance the capacity of health facilities, and improve infrastructure. DATs have demonstrated their ability to strengthen user-HCW relationships and protect users from stigmatization. Additional efforts are required to scale up the DAT program in the Philippines.

Indexed as

Health PersonnelMedication AdherenceQualitative ResearchTuberculosisAdultAntitubercular AgentsFemaleHumansInterviews as TopicMaleMiddle AgedPatient Acceptance of Health CarePhilippinesAntitubercular Agentsacceptabilitydigital adherencedigital adherence technologiesdigital healthhealth care workersimplementationinterviewinterviewsmedication adherencePhilippinesprivacyqualitative researchsupportsupport strategytuberculosistuberculosis treatmentuseruser privacy

Identifiers

PMID39042889
PMCPMC11303897

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.