Details of studies included in this systematic literature review
| Digital intervention | Objective | Method/ study design/ location | Subjects n | Intervention | Standard of care in control arm |
| Electronic medication monitors | |||||
| Broomhead [28] | To evaluate cost implications and health outcomes of the implementation of SIMPill, in new smear-positive TB patients receiving TB medication | A single-arm trial, with retrospective analysis of data from TB patients (historic controls) at a clinic in Northern Cape Province, South Africa | 120 participants (24 intervention, 96 in historic control arm), new smear-positive TB | SIMPill a pillbox which, when opened, sends an SMS to a server, indicating that the patient has taken their medication | DOT# |
| SMS reminders | |||||
| Bediang [31] | To evaluate the effectiveness of SMS reminders as an adjunct to DOT in improving TB treatment adherence and success. | Randomised, concealed, single-blinded controlled trial conducted at 12 TB treatment centres in Yaoundé, Cameroon | 279 patients with active TB (137 in intervention group, 142 in control group) | One-way SMS; daily reminders for TB medication as adjunct to DOT | DOT# |
| Iribarren [29] | To evaluate the acceptance and feasibility of a patient-based text intervention to promote their adherence to TB treatment | Randomised, concealed non-blinded controlled trial, conducted within a specialised hospital in Buenos Aires, Argentina | 37 newly diagnosed TB patients (18 in intervention group, 19 in control group) | Two-way SMS; patients were instructed to SMS the clinic after self-administration of medication as a proxy of adherence (they received reminders if they did not send a message) | SAT |
| Mohammed [30] | To measure the impact of a two-way SMS reminder system on TB treatment outcomes | Randomised, non-blinded controlled trial at TB treatment facilities in Karachi, Pakistan | 2207 newly diagnosed TB patients (1110 in intervention arm, 1097 in control arm) | Two-way SMS; daily automated SMS reminders sent at prescheduled time Patient responds back via SMS or phone call | DOT# |
| Video-observed therapy | |||||
| Chuck [22] | To determine whether video technology for remote observation of patients on anti-TB treatment (VOT) is as effective as in-person DOT | Prospective cohort study 390 patients using DOT for TB treatment support, New York, USA | 61 patients (16%) were assigned to VOT and 329 (84%) to in person DOT | VOT worker and patient pre-arranged a schedule for the VOT calls | DOT# |
| Wade [23] | To assess the effectiveness related to patient compliance, cost effectiveness, acceptability and sustainability of video-based DOT | A retrospective cohort design was used, recipients of VOT were compared to in-person-DOT recipients using data at a facility in Adelaide, South Australia | 128 patients with active TB at the community nursing service (58 in intervention group, 70 in control group) | VOT; patients received daily video calls from the facility | DOT* |
| SMS reminders, medication/electronic monitors (evaluated alone or in combination) | |||||
| Liu [32] | To evaluate the effectiveness of text messaging and medication monitors in improving TB medication adherence | Cluster randomised trial (using stratification and restriction) conducted in four provinces in China | 4173 TB patients (1104 control, 1008 SMS arm, 997 MM arm, 1064 combined SMS and MM) | Two-way SMS, MM or combination of two-way SMS and MM reminders on dose days to take medicine and to attend follow-up visits Physicians were advised to provide more active follow-up to patients with adherence issues | DOT# and MM without reminders |
TB: tuberculosis; MM: medication monitor; SMS: short message service; DOT: directly observed treatment; SAT: self-administered treatment. #: patients on in-person DOT were defined as those who had doses of medication observed at a health department or hospital clinic or in the community, and did not receive the intervention being evaluated in the study. Depending on the study, some treatment doses in the “DOT” arm were, in fact, self-administered.