结核病患者的初次失访：基于病房的外展团队和短信服务（SMS）技术的作用（研究提案）
Initial loss to follow up among tuberculosis patients: the role of Ward-Based Outreach Teams and short message service (SMS) technology (research proposal).
作者信息
Mwansa-Kambafwile Judith R M, Chasela Charles, Ismail Nazir, Menezes Colin
机构信息
Department of Public Health, University of Witwatersrand, Johannesburg, South Africa.
Centre for Tuberculosis, National Institute of Communicable Diseases, Johannesburg, South Africa.
出版信息
BMC Res Notes. 2019 Nov 8;12(1):737. doi: 10.1186/s13104-019-4757-3.
INTRODUCTION
Tuberculosis (TB) is a problem in South Africa. Initial loss to follow up (LTFU) among TB patients is high varying between 14.9 and 18%. Some of the reasons for this are: lack of proper communication between patient and staff on next steps after testing, not aware that results are ready; and other competing priorities. Receiving reminder messages that result is ready is an intervention that can be explored to reduce initial LTFU. This can be through either receiving a note from the Ward-Based Outreach Teams (WBOTs) or via short message service (SMS) advising the patient to collect test result at the facility. This proposal aims to assess the effectiveness of WBOTs or SMS technology in reducing TB initial LTFU.
METHODS
This will be a mixed methods approach. In depth interviews with WBOT Managers and TB Program Managers will be conducted. Focus group discussions with WBOT members will also be conducted. Two interventions (enhanced WBOTs/SMS technology) will be tested using a 3 arm randomized controlled trial (standard of care, SMS technology or enhanced WBOTs). The WBOTs will deliver paper note reminders while SMS intervention will entail sending reminder SMS messages to patients as soon as TB results are ready.
引言
结核病是南非面临的一个问题。结核病患者的初始失访率很高，在14.9%至18%之间波动。造成这种情况的一些原因包括：患者与工作人员之间在检测后下一步措施方面缺乏适当沟通、不知道检测结果已准备好；以及其他相互竞争的优先事项。接收检测结果已准备好的提醒信息是一种可以探索的干预措施，以减少初始失访率。这可以通过从基于病房的外展团队（WBOTs）收到便条，或通过短信服务（SMS）告知患者到医疗机构领取检测结果来实现。本提案旨在评估WBOTs或短信技术在降低结核病初始失访率方面的有效性。
方法
这将采用混合方法。将对WBOT经理和结核病项目经理进行深入访谈。还将与WBOT成员进行焦点小组讨论。将使用三臂随机对照试验（标准护理、短信技术或强化WBOTs）对两种干预措施（强化WBOTs/短信技术）进行测试。WBOTs将提供纸质便条提醒，而短信干预将在结核病检测结果一准备好就向患者发送提醒短信。
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