Impact of digital health interventions on study outcomes: intervention versus control groups
| First author [ref.] | Intervention | Subjects n control: intervention | Study outcome (definition) | Findings in control group/standard care % | Findings in intervention group% | Measure of effect (95% CI) |
| Broomhead [28] | MM# | 96:24 | Smear conversion rate at 2nd month | 38 | 63 | RR: 1.62 (1.09–2.42) |
| Cure rate: negative sputum smear in last month of treatment | 32 | 75 | RR: 2.32 (1.60–3.36) | |||
| Bediang [31] | SMS | 142:137 | Treatment success rate (assessed at 5th month) | 75 | 81 | RR: 1.45 (0.81–2.56) |
| Cure rate | 62 | 64 | RR: 1.06 (0.65–1.73) | |||
| Drop-out proportion, 6th month | 32 | 34 | RR: 1.08 (0.77–1.51) | |||
| Iribarren [29] | SMS | 19:18 | Adherence: self-reported adherence (booklets/calendars versus SMS)¶ | 53 | 77 | Not calculated¶ |
| Treatment success: cured or completed treatment | 90 | 94 | RR: 1.06 (0.87–1.28) | |||
| Mohammed [30] | SMS | 1097:1110 | Treatment success: cured or completed treatment | 83 | 83 | RR: 1 (0.96–1.04) |
| Completed: completed treatment but does not have a negative smear | 30 | 30 | RR: 1 (0.79–1.26) | |||
| Cure: sputum smear or culture-negative in the last month | 53 | 53 | RR: 1 (0.90–1.12) | |||
| Chuck [22] | VOT | 329:61 | Treatment completion | 97 | 96 | RR: 0.99 (0.93–1.05) |
| Adherence: appointment compliance (visits attended)+ | 91 | 95 | RR: 1.05 (1.04–1.06) | |||
| Wade [23] | VOT | 70:58 | Treatment completion | 33 | 48 | RR: 1.47 (0.96–2.25) |
| Adherence: observed doses§ | 69 | 88 | Not calculated## | |||
| Liu [32] | MM | 1091:992 | Non-adherence: months with at least 20% of doses missedƒ | 30 | 17 | aMR: 0.58 (0.42–0.79) |
| SMS | 1091:996 | Non-adherence: months with at least 20% of doses missedƒ | 30 | 27 | aMR: 0.94 (0.71–1.24) | |
| MM and SMS | 1091:1059 | Non-adherence: months with at least 20% of doses missedƒ | 30 | 14 | aMR: 0.49 (0.27–0.88) | |
| MM | 1066:955 | Poor treatment outcome: failure, death and LTFU | 9 | 6 | aRR: 0.71 (0.33–1.51) | |
| SMS | 1066:966 | Poor treatment outcome: failure, death and LTFU | 9 | 4 | aRR: 0.44 (0.17–1.13) | |
| MM and SMS | 1066:992 | Poor treatment outcome: failure, death and LTFU | 9 | 9 | aRR: 1.00 (0.45–2.20) |
MM: medication monitor; RR: risk ratio; SMS: short message service; VOT: video-observed therapy; aMR: adjusted means ratio; LTFU: loss to follow-up; aRR: adjusted risk ratio. #: historical control; ¶: adherence comparison between the intervention and control groups is hampered by the fact that 47% of the calendars were not returned for analysis; +: 3292 (95%) out of 3455 sessions scheduled for patients on VOT were successfully attended, compared to 32 204 (91%) out of 35 442 among patients on in-person DOT; §: calculated using data provided in original text articles; ƒ: mean of the percentage of patient-months on TB treatment where at least 20% of doses were missed; ##: could not be calculated, as no risk ratios were reported in the article and absolute numbers were not provided.