Improving Compliance to Tuberculosis Treatment: Supporting Patients through Mobile Graphic-based Reminders

Abstract

Background: Tuberculosis (TB) treatment is a complex task and requires medical supervision and support. The objective of this study was to assess the utility of a mobile graphic-based reminder (GBR) in improving compliance of patients with TB treatment. Compared to text and speech-based reminder systems, the visual or graphic application is suggested to be more effective in supporting treatment particularly in semi-literate and illiterate patients. 

Methods: The study was conducted in Zanzibar, Tanzania and included patients with active TB and already taking anti-TB drugs. The study was conducted over five weeks from July to August 2015. Participants were randomly assigned into three groups: control (n=10), speech-based reminder (n=10), and GBR (n=10) groups. Participants in the intervention groups (speech-based and GBR) received daily mobile reminder messages. Quantitative application responses and qualitative data resulting from semi-structured interviews from the patients were collected. Comparative analyses were undertaken between GBR and traditional care, and between GBR and speech-based reminders. 

Results: The findings indicated that the GBR system led to increase in treatment adherence (90%) compared with speech-based reminder (70%) and traditional care (60%). Findings also show that there were high efficacy and acceptability of mobile reminders in the GBR group with the average response rate of 60.1 compared with 50.6 in the speech-based reminder group (p<0.01). 

Conclusions: The GBR was more beneficial and accepted for use by the majority of the patients including those with limited education. This study suggests that mobile GBR system can be used to support compliance with the treatment regimen in both literate and illiterate TB patients.