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TB pillbox reminders beat SMS for doses

In a China cluster RCT, medication-monitor reminders cut poor TB adherence 40–50%, while text messages mainly reduced loss to follow-up.

Source

Effectiveness of Electronic Reminders to Improve Medication Adherence in Tuberculosis Patients: A Cluster-Randomised Trial

Liu X, Lewis JJ, Zhang H, et al. · PLoS medicine · 2015

doi.org/10.1371/journal.pmed.1001876Read the full paper ↗168 citationscc by

What they did

Across 36 clusters, investigators randomized pulmonary TB patients to control, SMS, medication monitor, or combined reminders and tracked missed doses and follow-up.

What they found

Medication monitors reduced poor adherence by 40–50% vs standard care; SMS alone did not improve adherence but cut loss to follow-up by 58%; 4,173 patients were analyzed.

The limits

What it doesn't show

Whether better adherence translates to microbiologic cure in this report, or how well monitors work outside China’s NTP.

Key terms

Medication monitor
Electronic pillbox that records openings and can remind patients.
SMS reminder
Text-message prompts to take TB medicines.
Cluster-randomised trial
Randomization of clinics/clusters rather than individuals alone.
Poor medication adherence
Missed doses based on pill counts and monitor/SMS failures.
Loss to follow-up
Patients dropping out of TB treatment observation.
DOT
Directly Observed Treatment strategy in TB control programs.

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Quiz yourself

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Medication monitors reduced poor adherence by about:

Common questions

What reduced poor adherence?

Medication-monitor reminders (about 40–50% reduction).

What did SMS achieve?

Did not cut poor adherence but reduced loss to follow-up by 58%.

How many patients were analyzed?

4,173 after exclusions.

How many clusters?

36 clusters screened 6,203 patients.

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