ArticleBMJ global health2025
Implementation outcomes of tuberculosis digital adherence technologies: a scoping review using the RE-AIM framework.
Article in BMJ global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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Who cites it
8 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
- Trial
- Time to first and recurrent missed video directly observed therapy sessions and associated factors among people with Tuberculosis in Kampala, Uganda.Frontiers in digital health · 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
- Contextual factors influencing implementation of tuberculosis digital adherence technologies: a scoping review guided by the RE-AIM framework.BMJ global health · 2025Article
- A process evaluation of an eHealth intervention to strengthen the circle of tuberculosis care in Shigatse, Tibet, China.PLOS global public health · 2025Article
- Digital interventions in medication adherence: a narrative review of current evidence and challenges.Frontiers in pharmacology · 2025Review
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
introductionGlobally, tuberculosis (TB) remains one of the leading infectious causes of death, with 1.3 million deaths. Digital adherence technologies (DATs) have the potential to provide person-centred care and improve outcomes. Using the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) framework, we conducted a scoping review of DAT implementations for TB treatment.
methodsWe searched seven databases for papers published between January 2000 and April 2023, using keywords for 'tuberculosis' and 'digital adherence technology'. Articles meeting prespecified inclusion criteria and containing data on RE-AIM domains were included. We defined 'reach' as comprising cellphone ownership and engagement by people with TB (PWTB) with DATs, 'adoption' as engagement by healthcare providers with DAT programmes, 'implementation' as the fidelity of the DAT programme implemented and 'maintenance' as longer-term uptake of DATs.
resultsOf 10 313 records, 102 contributed to the synthesis. DATs included short message service (SMS), phone, 99DOTS, video-supported therapy (VST) and pillboxes. For 'reach', across various settings, cellphone access varied from 50%-100% and 2%-31% of PWTB was excluded from accessing DATs due to technology challenges. 36%-100% of PWTB agreed to use a DAT. The weighted mean of DAT engagement over dose-days was 81% for SMS, 85% for phone, 61% for 99DOTS, 87% for pillbox and 82% for VST. Concerning 'implementation', the fidelity of DAT implementations was affected by technological issues such as cellphone coverage, DAT malfunction and provider-facing issues, including failure to initiate intensified patient management following low DAT engagement. Findings related to RE-AIM dimensions of 'adoption' and 'maintenance' were limited.
conclusionOur findings suggest that the 'reach' of DATs may be limited by a cascade of barriers, including limitations in cellphone accessibility and suboptimal sustained DAT engagement by PWTB. Video and pillbox DATs have higher levels of engagement. Implementation challenges included technological and provider-facing issues. Improving implementation outcomes may be important for TB DATs to achieve a broader public health impact. PROSPERO REGISTRATION NUMBER: CRD42022326968.
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