Evaluation of M-Health On Medication Adherence In Tuberculosis Patients: A Systematic Review

Background & Aim: The success of the TB control program is closely related to patient adherence to treatment. Previous studies have provided many views regarding the use of variants of mHealth on TB patient adherence, but the results still need to be clarified. This review aims to evaluate and provide an overview of mHealth RCTs on medication adherence in the patient with tuberculosis. Methods & Materials: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline was followed to report study findings. A literature search for studies in the period of 2018-2022 in PubMed, Cochrane, CINAHL and Sciencedirect databases was conducted. Randomized controlled trials (RCTs) that analyzed the effect of mHealth on medication adherence outcomes (treatment completion, treatment adherence, missed doses, and non-completed rate) were included. Adult patients with either active or latent TB infection were included. The Cochrane ’Risk of bias’ assessment tool was used to assess the risk of bias of eligible studies. Result: Overall, searches on databases generated 2,607 articles, and only 18 articles met the criteria. Two authors independently screened and extracted data from eligible studies. There are two devices used in mHealth in the last five years: software (SMS, We chat, and Whatsapp) and hardware (MERM, eDOT, WOT). Based on descriptive analysis, the hardware mHealth is superior to the software mHealth. Close monitoring and measurement of the use of DOT hardware demonstrates the accuracy of treatment success. Conclusion: It was found that mHealth interventions can be an advantageous approach. However, the interventions showed variable effects regarding the direction of effect and the rate of improvement of TB treatment adherence and clinical outcomes.