REMIND-TB
REMIND TB is an implementation research project which investigates the implementation and effectiveness of a real-time medication monitoring (RTMM) device called evriMED. This device records all box openings as medication intakes and sends reminder SMS to patients when the box is not opened. It was a two-armed cluster randomized trial with the interventional arm using evriMED and the control arm receiving standard TB care. The evriMED box was used to store and take patient’s medication. Medication intakes are measured through box openings which trigger and send real-time electronic signals to the central server. In case mediation is not taken on time, the patient receives a reminder SMS. Patients are followed up for six months to determine their adherence using the WHO cut-off points at 80%, 90% and 100%. We also determined participants’ adherence based pharmacy refill counts and self-report.
We recruited a total of 507 participants, 279 in the intervention arm (55%) and 228 in the control arm. Data from evriMED adherence reports showed that 8 (2.9%) patients reached 100% adherence, 98 (35.1%) reached adherence >90% and 133 (47.7%) reached adherence >80% in the intervention group.
We analyzed data by calculating adherence from the missed pills and compared the mean adherences. Preliminary analyses showed that based on pharmacy refill the mean adherence (SD) was 83% in the control group while in the intervention group it was 94%; P-value=0.000). There was no difference in self-reported adherence between the arms; 99% in the intervention group and 99% in the control group (p-value 0.86). We conclude that evriMed was effective in improving adherence to TB treatment.Based on the pharmacy refill, the intervention therefore had a significant effect on improving adherence.
