School of Public Administration, Inner Mongolia University, Hohhot, China.
School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China.
Health Res Policy Syst. 2023 Nov 1;21(1):115. doi: 10.1186/s12961-023-01054-x.
Tuberculosis (TB) has been regarded as 'a relentless scourge', increasing morbidity and mortality and burdening vulnerable populations. Poor adherence to TB treatment and ineffective traditional interventions hinders TB control. A novel TB approach called 'electronic monitors', equipping medication boxes with daily audio or visual reminders for electronically monitoring medication intake, seems promising in improving adherence and health outcomes and overcoming the weaknesses of traditional interventions. However, no review has systematically examined and synthesized the influencing factors of implementing electronic monitors. Implementation research offers the means to analyse the influencing factors of the implementation and its process, fitting well with the aim of this review. Therefore, the widely recognized Consolidated Framework for Implementation Research (CFIR), which offers a common taxonomy for evaluating intervention implementation, will be adopted to systematically identify barriers and facilitators of the electronic monitors for improving adherence and health outcomes in patients with TB.
The systematic review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Literature research will be conducted in five electronic databases (Ovid MEDLINE, CINAHL, EMBASE, Cochrane Library and Web of Science) to identify the barriers and facilitators of implementing electronic monitors in patients with TB. The CFIR will be used as a guide for categorizing and synthesizing the barriers and facilitators. Study screening, data extraction, quality appraisal and data analysis will be conducted by two independent reviewers. The use of additional reviewers will solve any disagreements between the two reviewers.
Given the increased prominence of TB epidemiology and the adherence problem of electronic monitors, there is a solid rationale for synthesizing the existing studies via the CFIR. The findings and conclusion of this review will lay bare the achievements and effectiveness of implementing electronic monitors, as well as the attendant gaps and limitations. Further strategies for facilitating the implementation of electronic monitors will also be explored. This review will be of essential significance for research and practice, supporting future academic research initiatives centred on patients with TB and aiding electronic monitor design in lowering the morbidity and mortality associated with TB disease.
PROSPERO: CRD42023395747.
结核病（TB）一直被视为“无情的祸害”，增加了发病率和死亡率，给弱势群体带来了负担。TB 治疗的依从性差和传统干预措施的无效阻碍了 TB 的控制。一种新的 TB 方法称为“电子监测器”，它为药盒配备了每日音频或视觉提醒，以电子方式监测药物摄入，似乎有望提高依从性和健康结果，并克服传统干预措施的弱点。然而，尚无综述系统地检查和综合实施电子监测器的影响因素。实施研究提供了分析实施及其过程影响因素的手段，非常适合本综述的目的。因此，将采用广泛认可的实施研究综合框架（CFIR）来系统地确定电子监测器改善 TB 患者依从性和健康结果的障碍和促进因素。
系统综述将遵循系统评价和荟萃分析的首选报告项目（PRISMA）指南。将在五个电子数据库（Ovid MEDLINE、CINAHL、EMBASE、Cochrane 图书馆和 Web of Science）中进行文献研究，以确定在 TB 患者中实施电子监测器的障碍和促进因素。CFIR 将用于对障碍和促进因素进行分类和综合。将由两名独立评审员进行研究筛选、数据提取、质量评估和数据分析。如果两名评审员之间存在分歧，将使用额外的评审员来解决。
鉴于 TB 流行病学的重要性以及电子监测器的依从性问题，通过 CFIR 综合现有研究具有充分的理由。本综述的发现和结论将揭示实施电子监测器的成就和有效性，以及随之而来的差距和局限性。还将探讨促进电子监测器实施的进一步策略。本综述对研究和实践具有重要意义，支持以 TB 患者为中心的未来学术研究计划，并有助于电子监测器设计降低与 TB 疾病相关的发病率和死亡率。
PROSPERO：CRD42023395747。
