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A novel approach to monitoring adherence to preventive therapy for tuberculosis in adolescence
M Starr1, S M Sawyer1, J B Carlin1
1Department of Microbiology and Infectious Diseases,,Centre for Adolescent Health,,Clinical Epidemiology and Biostatistics Unit,,Department of Thoracic Medicine,,Department of Biomedical Engineering, Royal Children's Hospital, Parkville, Victoria, Australia.
Objectives:
To evaluate the usefulness of a microelectronic tablet-dispenser for monitoring adherence to preventive therapy for tuberculosis infection in adolescents.
Methodology:
Twenty-one patients with positive Mantoux tests were treated with isoniazid (INH), dispensed in a microelectronic tablet-dispenser that recorded the date, time and duration that the container was opened. Other measures of adherence included attendance at clinic, patient self-report, tablet count, and measurement of urinary INH metabolites.
Results:
The mean adherence rates were: 83% using attendance at clinic, 91% using tablet counts, 79% using urine assays, and 66% using the electronic tablet-dispenser. Self-reporting appeared to over-estimate adherence.
Conclusions:
Adherence to 6 months of INH calculated using different measures is higher in this study than in previous reports. Microelectronic tablet-dispensers are an effective method to objectively measure adherence on a daily basis. Other measures are less helpful.
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