Institute for Tuberculosis Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei, China.
Wuhan Pulmonary Hospital, Wuhan Institute for Tuberculosis Control, Wuhan, Hubei, China.
Front Public Health. 2023 Mar 1;11:1033532. doi: 10.3389/fpubh.2023.1033532. eCollection 2023.
Digital technologies can improve adherence to tuberculosis (TB) treatment. We studied the impact of digitizing TB treatment monitoring on adherence among TB patients in Wuhan, China, during 2020-2021.
We compared an electronic system introduced to monitor TB medication adherence (e-Patient Service System; e-PSS) with the p paper-based standard of care (TB Control Information System; TCIS) in terms of prescribed TB treatment doses taken by patients and patient outcome after six months of follow up. We designed a cross sectional study using retrospective data for all drug susceptible pulmonary TB patients recorded on both systems. The main indicators were: compliant first follow up visit (within 3 days of start of treatment); medication adherence (80% or more of monthly doses taken); and end of treatment success ratio.
A total of 1,576 TB patients were recorded in TCIS in July September, 2020 and 1,145 TB cases were included in e-PSS in January March, 2021. The distribution of patient demographic and clinical features was similar between the two groups. A larger proportion from the e-PSS group visited the community doctor in the first three days compared with the TCIS group (48.91 versus 29. 76 % respectively). Medication adherence was also higher in the e-PSS group during the 6 months of treatment than in the TCIS group (84. 28 versus 80.3 3 % respectively). Treatment success was 92.52% in the e-PSS group and 92.07% in the TCIS group. Multivariate logistic regress ion analysis demonstrated that adjusted odds ratios for compliant first follow up visit, medication adherence and favorable treatment outcome in the e-PSS versus TCIS groups were 2.94 (95% 2.47 3.50), 1.33 (95% 1.08 1.63), and 1. 12 (95% CL: 0.79 1.57) respectively.
This study revealed improvements in TB care following an intervention to monitor treatment digitally in patients in Wuhan, China.
数字技术可以提高结核病（TB）治疗的依从性。我们研究了 2020-2021 年期间在中国武汉将结核病治疗监测数字化对结核病患者依从性的影响。
我们比较了电子系统（电子患者服务系统；e-PSS）和纸质标准护理（结核病控制信息系统；TCIS）在患者接受规定的结核病治疗剂量和六个月随访后的患者结局方面的效果。我们使用回顾性数据对两种系统记录的所有药敏性肺结核患者进行了一项横断面研究。主要指标是：按时进行第一次随访（开始治疗后 3 天内）；药物依从性（每月剂量的 80%或以上）；以及治疗结束成功率。
2020 年 7 月至 9 月，TCIS 系统记录了 1576 例结核病患者，2021 年 1 月至 3 月，e-PSS 系统记录了 1145 例结核病病例。两组患者的人口统计学和临床特征分布相似。与 TCIS 组相比，e-PSS 组在头三天内看社区医生的比例更高（分别为 48.91%和 29.76%）。在 6 个月的治疗期间，e-PSS 组的药物依从性也高于 TCIS 组（分别为 84.28%和 80.33%）。e-PSS 组的治疗成功率为 92.52%，TCIS 组为 92.07%。多变量逻辑回归分析表明，e-PSS 组与 TCIS 组相比，按时进行第一次随访、药物依从性和良好治疗结局的调整比值比分别为 2.94（95%置信区间：2.47-3.50）、1.33（95%置信区间：1.08-1.63）和 1.12（95%可信区间：0.79-1.57）。
本研究揭示了在中国武汉对患者的治疗进行数字化监测干预后，结核病护理得到了改善。
