Abstract
BackgroundCompliance to anti-TB treatment is crucial in achieving cure and avoiding the emergence of drug resistance. Electronic health (eHealth) interventions are included in the strategy to end the global Tuberculosis (TB) epidemic by 2035. Evidences showed that mobile messaging systems could improve patient adherence to clinic appointment for diagnosis and treatment. This review aimed to assess the effect of mobile-phone messaging on anti-TB treatment success.MethodsAll randomized controlled trial (RCT) and quasi-experimental studies done prior to August 26, 2019 were included in the review. Studies were retrieved from PubMed, EMBASE, Cochrane and ScienceDirect databases including, grey and non-indexed literatures from Google and Google scholar. Quality of studies were independently assessed using Cochrane Risk of Bias Assessment Tool. A qualitative synthesis and quantitative pooled estimation were used to measure the effect of phone messaging on TB treatment success rate. PRISMA flow diagrams were used to summarize article selection process.ResultsA total of 1237 articles were identified, with 14 meeting the eligibility criteria for qualitative synthesis. Eight studies with a total of 5680 TB patients (2733 in intervention and 2947 in control groups) were included in meta-analysis. The pooled effect of mobile-phone messaging revealed a small increase in treatment success compared to standard of care (RR 1.04, 95% CI 1.02 to 1.06), with low heterogeneity (I2 = 7%, p < 0.0002). In the review, performance, detection and attrition biases were reported as major risk of biases.ConclusionsMobile-phone messaging showed a modest effect in improving anti-TB treatment success; however, the quality of evidence was low. Further controlled studies are needed to increase the evidence-base on the role of mHealth interventions to improve TB care.Protocol registration numberCRD420170744339. http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42017074439
Highlights
Compliance to anti-TB treatment is crucial in achieving cure and avoiding the emergence of drug resistance
Selection of studies Articles were retrieved from databases including PubMed (552), EMBASE (344), ScienceDirect (168), Cochrane (92) and grey literature from Google Scholar (78) and reference lists (3), as shown in the flow diagram for selection processes (Fig. 1)
The meta-analysis has shown that phone messaging group had a modest increment in treatment success rate compared to standard care (RR 1.04, 95% CI 1.02 to 1.06) with low heterogeneity (I2 = 7%, p < 0.0002) between individual studies based on the cutoff value [28]
Summary
Compliance to anti-TB treatment is crucial in achieving cure and avoiding the emergence of drug resistance. Electronic health (eHealth) interventions are included in the strategy to end the global Tuberculosis (TB) epidemic by 2035. Evidences showed that mobile messaging systems could improve patient adherence to clinic appointment for diagnosis and treatment. This review aimed to assess the effect of mobile-phone messaging on anti-TB treatment success. Electronic Health interventions has brought attention in the strategy to end the global TB epidemic by 2035 [8]. Electronic based patient education was components of a WHO conceptual framework for digital health in the TB response. This was intended to be accomplished using video (virtually) observed therapy [10], Short Message Service (SMS) and eLearning [11]
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