Arcady Group team members co-authored a paper that is now available with open access online in The Lancet. The article entitled Digital adherence technologies to improve tuberculosis treatment outcomes in China: a cluster-randomized superiority trial aimed to evaluate the effect of a daily reminder medication monitor, monthly review of adherence data by the health-care provider, and differentiated care for patients with adherence issues, on tuberculosis treatment adherence and outcomes.
Although the digital medication monitor intervention had a very significant positive impact on medication adherence, it had no effect on unfavorable outcomes, which included loss to follow-up during treatment, tuberculosis recurrence, death, and treatment failure. Importantly, and unfortunately, there was a failure to change patient management following identification of treatment non-adherence at monthly reviews – thus there was not the “differentiated care” intended. As a result, questions remain. As noted in the paper, “a better understanding of adherence patterns and how they relate to poor outcomes, coupled with a more timely review of adherence data and improved implementation of differentiated care, may be required.”