Implementation of Tuberculosis Monitoring Encouragement Adherence Drive (TMEAD) for improving treatment adherence amongst drug-resistant Tuberculosis patients in Ahmedabad City, Gujarat.

AbstarctO_ST_ABSBackgroundC_ST_ABSTreatment Adherence among Tuberculosis (TB) patients is a critical challenge globally and in India. Digital technology has appeared as a tool for providing patient centric monitoring support to improve TB patients drug adherence. However, there is a paucity of evidence on the acceptability and effectiveness of such devices for enhancing adherence among drug-resistant TB (DRTB). The present study aims to document the feasibility of using the Tuberculosis Monitoring Encouragement Adherence Drive (TMEAD) and treatment adherence amongst DRTB patients. MethodsA longitudinal follow-up study of DRTB patients was conducted in Ahmedabad. A total of 22 Tuberculosis Units (TUs) from Ahmedabads rural and urban regions were included in the study based on the high load of DR-TB patients. Two hundred patients were enrolled per the inclusion criteria, and the TMEAD device was deployed to the enrolled patients and followed up monthly for six months to document drug adherence and various challenges. ResultMore than 80.5% of the patients used the device, and the point drug adherence was 92% among the patients who used the device. About 19.5% did not use the device, and the reasons for the non-use of the device include non-functional devices and alarms, charging, and incomplete refilling with prescribed drugs. The other significant issues include the social stigma regarding the disease and the fear of disclosure of TB. ConclusionThe present study revealed that the acceptability of TMEAD and patient reported drug adherence were high. However, there were various disease and device related challenges. The implementation of TMEAD can be improved through the design modification. Further large-scale research is required to document the effectiveness of the device and scale up.