基于电子药物监测器的综合方案对改善西藏结核病患者治疗结果的有效性:多中心随机对照试验
Xiaolin Wei1, Joseph Paul Hicks2, Zhitong Zhang3
1Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Lancet (London, England)
|February 3, 2024
概括
电子药物监测显著改善了西藏的结核治疗效果. 这种数字粘附技术为高负担,低资源的设置提供了有前途的解决方案.
科学领域:
- 公共卫生
- 传染性疾病
- 数字健康
背景情况:
- 结核病治疗的坚持对于有效的治疗至关重要.
- 世界卫生组织推直接观察治疗 (DOT),但成本高且不方便.
- 电子药物监测器 (EMM) 是一种数字依附技术 (DAT),其有效性的证据尚不确定.
研究的目的:
- 评估使用EMM治疗西藏结核病患者的综合方案的有效性.
- 在资源有限的环境中评估EMM对治疗坚持和结果的影响.
主要方法:
- 一个多中心的随机对照试验在西藏的Shigatse进行,对278名15岁以上的药物敏感结核病患者进行了试验.
- 干预组获得了带有提醒,远程监控和智能手机应用程序的EMM.
- 对照组接受了通常的护理以及无数据访问或应用支持的禁用EMM.
主要成果:
- 月经不稳定率从对照组的37%下降到干预组的10% (调整后的风险差异: -29. 2pp; p< 0. 0001).
- 与对照组相比,干预组的治疗成功率显著提高 (94%) (调整后的风险差异: 21 pp; p< 0. 0001).
- 在六个二次治疗结果中,有五个显然改善了EMM干预.
结论:
- 包括电子药物监测器在内的综合方案有效改善了结核病治疗的坚持和结果.
- 这种数字化执法技术显示出可能对高负担,低资源环境中的结核病计划产生积极影响.
- 这种药物是对传统结核病治疗策略的有效补充.
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