数字坚持技术以改善结核病患者的药物坚持:系统性审查和元分析随机对照试验
Agus Santosa1,2, Neti Juniarti3, Tuti Pahria4
1Nursing Doctoral Program, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, Indonesia. agus24003@mail.unpad.ac.id.
NPJ primary care respiratory medicine
|November 21, 2025
概括
与直接观察治疗 (DOT) 相比,数字坚持技术 (DAT) 显著改善了结核病 (TB) 药物坚持. 这些数字工具为全球结核病控制提供了更有效的策略.
科学领域:
- 公共卫生 公共卫生
- 传染病流行病学 传染病流行病学
- 数字健康数字健康
背景情况:
- 药物坚持对于成功结核病 (TB) 治疗结果至关重要.
- 不遵守结核病药物仍然是一个重大的全球挑战,阻碍了有效的结核病控制工作.
- 数字坚持技术 (DAT) 在支持患者坚持方面表现有前途,但它们的比较有效性需要严格的评估.
研究的目的:
- 系统地审查和元分析随机对照试验 (RCT),比较DAT与直接观察治疗 (DOT) 在改善结核病药物治疗的有效性.
- 评估各种类型的DAT的影响,包括短信提醒,视频观察治疗 (VOT),药物事件提醒监视器 (MERM),生物识别监控系统 (BMS) 和摄入传感器 (IS).
主要方法:
- 在主要数据库 (PubMed,Scopus,EBSCO,ScienceDirect) 进行了全面的文献搜索,截至2024年11月7日.
- 包括19个涉及超过10,000名结核病患者的RCT,数据被提取并由多个审查者评估质量.
- 使用随机效应模型进行了元分析,结合了子组,灵敏度和出版偏差分析,并遵守PRISMA 2020指南.
主要成果:
- 与直接观察治疗 (DOT) 相比,数字坚持技术 (DAT) 在结核病药物坚持方面表现出显著的改善,整体赔率比为2.853 (p < 0.001).
- 小组分析证实了VOT,MERM和SMS提醒的有效性,摄入传感器 (IS) 和BMS显示了最大的效果大小.
- 效果因国家收入水平而异,在高收入和中高收入国家,DAT更有效;由于研究有限,在低收入国家发现的结果是不确定的.
结论:
- 数字坚持技术 (DAT) 在增强结核病患者的药物坚持方面明显比直接观察疗法 (DOT) 更有效.
- 量身定制的实施策略对于在各种医疗保健系统中最佳选择和整合DAT至关重要.
- 这些发现支持扩大适合环境的数字工具,以支持全球结核病控制倡议.
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