Adherence Support Coalition to End TB: evaluation of digital adherence technologies for TB treatment in Ethiopia

Conditions

Tuberculosis

Tadesse AW, Sahile M, Foster N, McQuaid CF, Weldemichael GT, Abdurhman T, Mohammed Z, Belachew M, Shiferaw A, Assefa D, Gadissa D, Yazew H, Yakob N, Shewamene Z, Goscé L, van Rest J, Madden N, Charalambous S, van Kalmthout K, Bedru A, Letta T, Jerene D, Fielding KL.

2025-09-29

10.1016/j.landig.2025.100895

Feasibility and acceptability of the smart pillbox and medication label with differentiated care to support person-centered tuberculosis care among ASCENT trial participants – A multicountry study

Amare Worku Tadesse, Andrew Mganga, Tanyaradzwa Dube, Jason Alacapa, Kristian van Kalmthout et al. (13 authors)

Frontiers in Public Health2024-02-2011 citations

10.3389/fpubh.2024.1327971

Evaluating the equity impact and cost-effectiveness of digital adherence technologies with differentiated care to support tuberculosis treatment adherence in Ethiopia: protocol and analysis plan for the health economics component of a cluster randomised trial.

Foster N, Tadesse AW, McQuaid CF, Gosce L, Abdurhman T, Assefa D, Bedru A, Houben RMGJ, van Kalmthout K, Letta T, Mohammed Z, van Rest J, Umeta DG, Weldemichael GT, Yazew H, Jerene D, Quaife M, Fielding KL.

2023-04-245 citations

10.1186/s13063-023-07289-x

Evaluation of implementation and effectiveness of digital adherence technology with differentiated care to support tuberculosis treatment adherence and improve treatment outcomes in Ethiopia: a study protocol for a cluster randomised trial.

Tadesse AW, Mohammed Z, Foster N, Quaife M, McQuaid CF, Levy J, van Kalmthout K, van Rest J, Jerene D, Abdurhman T, Yazew H, Umeta DG, Assefa D, Weldemichael GT, Bedru A, Letta T, Fielding KL.

2021-11-1020 citations

10.1186/s12879-021-06833-x

Interventions

EvriMed Device medical monitor and differentiated response to patient adherence

medication sleeves or label and differentiated response to patient adherence

Standard of care

Eligibility

Sex/Gender

All

Inclusion criteria

Inclusion criteria: Adults (=18 years, male and female) with pulmonary DS-TB Adult with pulmonary DS-TB who are initiated on TB treatment using fixed dose combination (FDC) at the health facility Adult with pulmonary DS-TB who have provided informed consent.

Exclusion criteria

Exclusion criteria: Patients who expect to leave the study area at any time during the treatment or follow up period Critically ill patients receiving in-patient care or palliative care

Design outcomes

Primary

Measure	Time frame
The proportion of adult pulmonary DS-TB participants with unfavourable outcome, defined as poor end of treatment outcome (lost to follow-up, death or treatment failure) or treatment recurrence up to 6 months after the scheduled end of treatment (defined as restarting TB treatment or sputum culture positive 12 months after enrolment). Each intervention arm will be compared to the standard of care arm.	—

Measure

Time frame

The proportion of adult pulmonary DS-TB participants with unfavourable outcome, defined as poor end of treatment outcome (lost to follow-up, death or treatment failure) or treatment recurrence up to 6 months after the scheduled end of treatment (defined as restarting TB treatment or sputum culture positive 12 months after enrolment). Each intervention arm will be compared to the standard of care arm.

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Secondary

Measure	Time frame
Patterns of longitudinal technology engagement in the intensive and continuation phases. ;To describe the fidelity and characteristics associated with successful use of to the intervention among adult pulmonary DS-TB participants, including web-based platform usage statistics, technology failures or inability to engage with the DAT and cell phone access. ;To describe the longitudinal technology engagement (smart pill box and video supported treatment) and interim treatment outcomes among DR-TB participants enrolled;To project the direct and indirect epidemiological impact of scale-up of (i) smart pill box and (ii) medication sleeve, with daily monitoring and differentiated response to patient adherence compared with the standard of care as measured by the change in unfavourable outcome in the intervention relative to the standard of care among adult pulmonary DS-TB participants;To estimate the cost-effectiveness of the two interventions from a health system perspective compared to the standard of care among adult pulmonary DS-TB participants;To explore the institutional feasibility and acceptability of implementing (i) smart pill box and (ii) medication sleeve for daily monitoring, with differentiated response to patient adherence in adult DS-TB and DR-TB participants (smart pill box only). ;The proportion of adult pulmonary DS-TB participants who have poor treatment outcome (lost to follow-up, death during treatment or treatment failure). Each intervention arm will be compared to the standard of care arm. ;The proportion of adult pulmonary DS-TB participants who are lost to follow-up during treatment. Each intervention arm will be compared to the standard of care arm.;The proportion of adult pulmonary DS-TB participants with unfavourable outcome (comparing the two intervention arms).	—

Measure

Time frame

Patterns of longitudinal technology engagement in the intensive and continuation phases. ;To describe the fidelity and characteristics associated with successful use of to the intervention among adult pulmonary DS-TB participants, including web-based platform usage statistics, technology failures or inability to engage with the DAT and cell phone access. ;To describe the longitudinal technology engagement (smart pill box and video supported treatment) and interim treatment outcomes among DR-TB participants enrolled;To project the direct and indirect epidemiological impact of scale-up of (i) smart pill box and (ii) medication sleeve, with daily monitoring and differentiated response to patient adherence compared with the standard of care as measured by the change in unfavourable outcome in the intervention relative to the standard of care among adult pulmonary DS-TB participants;To estimate the cost-effectiveness of the two interventions from a health system perspective compared to the standard of care among adult pulmonary DS-TB participants;To explore the institutional feasibility and acceptability of implementing (i) smart pill box and (ii) medication sleeve for daily monitoring, with differentiated response to patient adherence in adult DS-TB and DR-TB participants (smart pill box only). ;The proportion of adult pulmonary DS-TB participants who have poor treatment outcome (lost to follow-up, death during treatment or treatment failure). Each intervention arm will be compared to the standard of care arm. ;The proportion of adult pulmonary DS-TB participants who are lost to follow-up during treatment. Each intervention arm will be compared to the standard of care arm.;The proportion of adult pulmonary DS-TB participants with unfavourable outcome (comparing the two intervention arms).

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Countries

Ethiopia

Contacts

Public ContactGediyon Teferra

Acting Manager

gediyon.teferra@kncvtbc.org+251116630145

Outcome results

None listed