实用集群随机试验的过程评估,用于支持结核病治疗的数字坚持技术:五个国家的混合方法研究
Norma Madden1, Amare W Tadesse2, Chung Lam Leung1
1Division of TB Elimination and Health Systems Innovation, KNCV Tuberculosis Foundation, 2516 AB The Hague, The Netherlands.
Tropical medicine and infectious disease
|March 26, 2025
概括
数字坚持技术 (DAT) 显示了患者对结核病治疗的高度参与. 然而,医疗保健提供者平台的使用量在不同国家之间有很大差异,这表明需要优化DAT实施以获得更好的结果.
科学领域:
- 数字健康数字健康
- 公共卫生 公共卫生
- 实施科学 实施科学
背景情况:
- 数字坚持技术 (DAT) 为以个人为中心的结核病 (TB) 护理提供了潜力.
- 虽然DATs是可以接受的,但它们在改善结核病治疗结果方面的有效性仍然不同.
- 了解DAT的实现忠实性对于优化其使用至关重要.
研究的目的:
- 在五个集群随机试验中评估数字坚持技术 (DAT) 的实施忠实性.
- 评估结核病患者 (PwTB) 和医疗保健提供者 (HCP) 与DAT干预的参与.
- 为了识别不同国家在DAT实施中的差异.
主要方法:
- 在埃塞俄比亚,菲律宾,南非,坦桑尼亚和乌克兰的试验中评估了两个DAT (智能药盒,药物标签).
- 利用一个框架来评估实施的投入,流程,输出和结果.
- 采用定量指标和定性子研究来评估忠诚度.
主要成果:
- 在结核病 (PwTB) 患者中观察到对DAT的高度参与,药片盒使用者显示持续参与 (82%-91%的数字记录剂量).
- 医疗保健提供者 (HCP) 登录到遵守平台的频率因国家而异 (埃塞俄比亚,坦桑尼亚,乌克兰的71%工作日,菲律宾和南非的42%-52%).
- 干预忠实度在参与国家之间表现出显著的差异.
结论:
- 数字坚持技术 (DAT) 表明患者在结核病治疗中的参与度很高.
- 医疗保健提供者 (HCP) 与数字平台的接触的变化突出了实施挑战.
- 优化DAT的实施对于最大限度地发挥其在不同环境中的结核病护理方面的潜在益处至关重要.
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