Digital health technology has been a popular topic of investigation across many healthcare disciplines. Several studies aim to see if these tools can improve patients’ adherence to treatment for ultimately better disease outcomes and management.
An analysis published today found that patients with Pulmonary tuberculosis (TB) They were able to improve their quality of life while reducing the huge costs that come with illness through the use of a digital Medication Event Reminder (MERM).
Secondary analysis of tuberculosis patients
The team of researchers, including Tsegahun Manyazewal, PhD, Center for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Addis Ababa University, focused on adults with new or previously treated pulmonary tuberculosis, bacterial confirmed, and drug-sensitive. Participating patients must be eligible to start first-line anti-tuberculosis therapy.
The study was a secondary analysis of a two-arm randomized trial. Pre-specified secondary endpoints—health-related quality of life (HRQoL), direct and indirect costs from the individual patient’s perspective, as well as co-factors associated with lower HRQoL and higher catastrophic costs—were adopted from the original trial.
The enrollment period was from June 2020 to June 2021 and a total of 109 eligible patients from 10 healthcare facilities in Ethiopia were included in the final analysis. After randomization, patients were given a 15-day supply of TB drugs for self-administration and refill throughout the 2-month observational treatment phase. The control group (n = 57) received standard directly observed treatment, while the intervention group (n = 52) received a medication-dispensing event reminder device and complementary treatment.
Health-related quality of life was measured using the EuroQoL 5-level 5-level tool (EQ-5D-5L) and the WHO Patient Costing Tool was implemented to assess direct (out of pocket) and indirect (guardian and adaptive) catastrophic costs.
Digital medication event reminder improves results
Secondary analysis showed a significant improvement in HRQoL in the intervention group compared to the control group, with no patients showing indications of severe or severe problems in any of the EQ-5D-5L sections.
Patients with the highest HRQoL scores showed no problems in the EQ-5D-5L dimensions of mobility (78.9%), self-care (80.7%), usual activities (61.5%), pain or discomfort (60.6%), and anxiety or depression (63.3%). . Conversely, among those with the most problems, such as pain or discomfort (39.4%) the most common problem was in the EQ-5D-5L dimensions while self-care (19.3%) was the least represented.
The comparison also revealed that the lower catastrophic cost rates among the intervention group were significant. The costs of treating TB among patients in the control group ranged from US$ 0–310.34, or ETB 0–16200, while the cost range for the intervention group was 0–8.81, or ETB 0–460 .
The status of the experimental group was the only deciding factor associated with low human heart rate. Important factors in catastrophic cost included experimental group placement, occupation, number of cohabitants, and smoking.
Patients in both groups faced catastrophic costs, however, and the difference was significant with 31 patients in the control group compared to 11 patients in the intervention group. Demographic data from the patient population showed that the mean age was 33.1 years, 66.1% were men, and 13.9% were HIV-positive.
The investigators concluded that patient-centered digital health technologies have the potential to overcome barriers to anti-tuberculosis treatment.
The authors conclude, “These findings suggest that digital health technologies may improve quality of life and reduce catastrophic costs among patients with pulmonary tuberculosis, particularly those who face structural barriers to standard treatment.”
the study, “Effect of digital drug event reminders and observed versus standard treatment on health-related quality of life and catastrophic costs in tuberculosis patients A secondary analysis of a randomized clinical trialPosted in Infectious Diseases JAMA.