Roberti Javier, Morelli Daniela Moraes, Aguilar-Vidrio Omar Alfonso, Suyanto Agnes, Carmiol-Rodriguez Priscilla, Tolentino Alejandra, Chen-Liang Enrique, Sprecher Jennifer, Rubinstein Fernando, Iribarren Sarah
CIESP, CONICET, Buenos Aires, Buenos Aires, Argentina
Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina.
BMJ Open. 2025 Sep 2;15(9):e095878. doi: 10.1136/bmjopen-2024-095878.
To explore patient perspectives on using a digital adherence technology (DAT) for tuberculosis (TB) treatment, specifically, the TB Treatment Support Tools (TB-TST) intervention, which integrates a mobile app designed to enhance patient-centred support, monitoring and communication, alongside a drug metabolite test.
Qualitative study conducted as part of a pragmatic randomised controlled trial.
Four public reference hospitals in Argentina. All patients in the intervention group were invited to participate; 33 patients in the intervention group and five treatment supporters were included.
semistructured interviews were conducted. The normalisation process theory guided analysis to understand factors that enable or hinder the intervention's integration into routine practice for TB treatment medication adherence.
Patients identified medication reminders, educational messages and direct communication with treatment supporters (TSs) as the most helpful components of the intervention. Many reported using the app to ask TSs questions they felt uncomfortable raising with physicians in person. Initially, many patients did not fully understand the purpose and use of the metabolite test. Over time, their understanding of the app improved, though some continued to misinterpret the test results. Motivation to adhere to TB treatment was primarily driven by a desire to protect family members and resume normal daily activities. Reported barriers to app use included time constraints due to work, technical issues, limited internet connectivity and the burden of medication side effects. While the intervention was generally perceived as supportive and user-friendly, patients suggested improvements such as faster response times from TSs, expanded availability and better technical reliability and internet access.
These findings highlight the importance of tailoring digital adherence interventions to meet the diverse needs of patients and reinforce the pivotal role of the TS as a trusted and accessible source of guidance throughout TB treatment.
NCT04221789; https://clinicaltrials.gov/ct2/show/NCT04221789.
探讨患者对于使用数字依从性技术（DAT）进行结核病（TB）治疗的看法，具体而言，是对结核病治疗支持工具（TB-TST）干预措施的看法。该干预措施整合了一款移动应用程序，旨在加强以患者为中心的支持、监测和沟通，并结合了药物代谢物检测。
作为一项实用随机对照试验的一部分进行的定性研究。
阿根廷的四家公共参考医院。邀请干预组的所有患者参与；干预组纳入了33名患者和五名治疗支持者。
进行了半结构化访谈。采用规范化过程理论指导分析，以了解促进或阻碍该干预措施融入结核病治疗药物依从性常规实践的因素。
患者认为药物提醒、教育信息以及与治疗支持者（TS）的直接沟通是该干预措施最有用的组成部分。许多患者报告称使用该应用程序向TS询问他们觉得当面与医生提出会感到不自在的问题。最初，许多患者并未完全理解代谢物检测的目的和用途。随着时间的推移，他们对该应用程序的理解有所改善，不过仍有一些患者继续误解检测结果。坚持结核病治疗的动力主要源于保护家人和恢复正常日常活动的愿望。报告的应用程序使用障碍包括工作导致的时间限制、技术问题、网络连接有限以及药物副作用带来的负担。虽然该干预措施总体上被认为具有支持性且用户友好，但患者建议进行改进，例如TS更快的响应时间、更广泛的可用性以及更好的技术可靠性和网络接入。
这些发现凸显了定制数字依从性干预措施以满足患者多样化需求的重要性，并强化了TS在整个结核病治疗过程中作为可信赖且易于获取的指导来源的关键作用。
NCT04221789；https://clinicaltrials.gov/ct2/show/NCT04221789 。
