Implementation and effectiveness of evriMED with short messages service (SMS) reminders and tailored feedback compared to standard care on adherence to treatment among tuberculosis patients in Kilimanjaro, Tanzania: proposal for a cluster randomized controlled trial
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Abstract
BACKGROUND: Adherence to tuberculosis (TB) treatment is challenging because of many factors. The World Health Organization has recommended the use of digital adherence monitoring technologies in its End TB Strategy. However, evidence on improving adherence is limited. EvriMED is a real-time medication-monitoring device which was found to be feasible and acceptable in a few studies in Asia. In Tanzania, however, there may be challenges in implementing evriMED due to stigmatization, network and power access, accuracy, and cost effectiveness, which may have implications for treatment outcome. We propose a pragmatic cluster randomized trial to investigate the effectiveness of evriMED with reminder cues and tailored feedback on adherence to TB treatment in Kilimanjaro, Tanzania. METHODS/DESIGN: We will create clusters in Kilimanjaro based on level of health care facility. Clusters will be randomized in an intervention arm, where evriMED will be implemented, or a control arm, where standard practice directly observed treatment will be followed. TB patients in intervention clusters will take their medication from the evriMED pillbox and receive tailored feedback. We will use the 'Stages of Change' model, which assumes that a person has to go through the stages of pre-contemplation, contemplation, preparation, action, and evaluation to change behavior for tailored feedback on adherence reports from the device. DISCUSSION: If the intervention shows a significant effect on adherence and the devices are accepted, accurate, and sustainable, the intervention can be scaled up within the National Tuberculosis Programmes. TRIAL REGISTRATION: Pan African Clinical Trials Registry, PACTR201811755733759 . Registered on 8 November 2018.
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A few other mobile health-based interventions have been successful focusing on vaccination, medication adherence, and counseling for different health services.
“In the KCMC community, mobile health technology is widely available, and a few other mobile health–based interventions have been successful focusing on vaccination [43], medication adherence [44,45], and counseling for different health services [46,47].”
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Digital adherence technologies for the treatment of tuberculosis: landscape and research prioritiesPreprint
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Staton, C. A., Friedman, K., Phillips, A. J., Minnig, M. C., Sakita, F. M., Ngowi, K. M., Suffoletto, B., Hirshon, J. M., Swahn, M., Mmbaga, B. T., et al. (2023) · PLOS ONE · doi:10.1371/journal.pone.0288458 · Cited by 14 · see citing works
Self-citationFeasibility of SMS booster for alcohol reduction in injury patients in Tanzania
Staton, C. A., Minnig, M. C., Phillips, A. J., Kozhumam, A. S., Pesambili, M., Suffoletto, B., Mmbaga, B. T., Ngowi, K., & Vissoci, J. R. N. (2022) · PLOS Global Public Health · doi:10.1371/journal.pgph.0000410 · Cited by 4 · see citing works
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- Authors
- Sumari-de Boer, M., Pima, F. M., Ngowi, K. M., Chelangwa, G. M., Mtesha, B. A., Minja, L. M., Semvua, H. H., Mpagama, S., Mmbaga, B. T., Nieuwkerk, P. T., & Aarnoutse, R. E.
- Affiliations
- Kilimanjaro Clinical Research Institute (TZ)
- Amsterdam UMC Location University of Amsterdam (NL)
- Radboud University Nijmegen (NL)
- ORCID
- Venue
- Trials
- Published
- 2019-07-12
- Volume
- 20
- Issue
- 1
- Pages
- 426-426
- ISSN
- 1745-6215 (ISSN-L)
- PMC
- PMC6626331
- OpenAlex
- W2962207721
- Cited by
- 27
- References
- 59
- Citations by year
- 2025: 1 · 2024: 9 · 2023: 8 · 2022: 3 · 2021: 4 · 2020: 1 · 2019: 1
- FWCI
- 2.32
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Trials (publishedVersion, cc-by)
- Research Square (acceptedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (submittedVersion, cc-by)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Stop TB partnership (1169)
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Infectious Diseases › Tuberculosis Research and Epidemiology
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- tuberculosis, medication adherence, SMS reminders, personalized feedback, directly observed therapy, stages of change, End TB Strategy, pillbox
- MeSH terms
- Adolescent, Adult, Aged, Antitubercular Agents, Cues, Female, Humans, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Tanzania, Time Factors, Tuberculosis, Multicenter Studies as Topic, Treatment Outcome, Reminder Systems, Feedback, Psychological, Medication Adherence, Young Adult, Text Messaging, Pragmatic Clinical Trials as Topic
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