Treatment adherence
TB pillbox reminders beat SMS for doses
Open access · cc by · source: Europe PMC
In a China cluster RCT, medication-monitor reminders cut poor TB adherence 40–50%, while text messages mainly reduced loss to follow-up.
Study at a glance
- Design
- RCT — Cluster RCT across 36 sites: control, SMS, medication monitor, or combined
- N
- N=4173 · Pulmonary TB patients in China’s NTP
- Population
- Pulmonary tuberculosis patients in China’s National Tuberculosis Control Program
- Outcome
- Poor medication adherence and loss to follow-up
Structured fields used in claim comparison tables when every cited study has a complete layer.
Key findings
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.
Methodology
Across 36 clusters, investigators randomized pulmonary TB patients to control, SMS, medication monitor, or combined reminders and tracked missed doses and follow-up.
Limitations
Whether better adherence translates to microbiologic cure in this report, or how well monitors work outside China’s NTP.
How this study connects
Role on claims
Each row is a claim on a concept or method page where this paper supports, challenges, or qualifies the statement. Roles are hand-checked — not a model guess.
Across 36 clusters, 4,173 pulmonary TB patients were assigned to control, SMS, medication monitor, or both. Medication monitors reduced poor adherence by 40–50% versus standard care; SMS alone did not improve adherence but cut loss to follow-up by 58%. Better dose-taking in this report is not the same as proven microbiologic cure, and performance outside China's NTP is untested.
Evidence for the claim as stated.
Process success and health success are not the same cluster-trial result. TSC moved toilets (~19 percentage points) without moving child health; TB medication monitors moved adherence 40–50% without, in this report, proving cure; SASA! moved IPV and concurrency by about 50% as the intended social outcome. A student who treats 'the cluster intervention worked' as one sentence will misread at least one of these papers.
Evidence for the claim as stated.
Open questions
Tensions this paper is part of
From concept pages' “where studies disagree.” Disagreement means the same question; scope means different assays, populations, or outcomes.
Process success and health success are not the same cluster-trial result. TSC moved toilets (~19 percentage points) without moving child health; TB medication monitors moved adherence 40–50% without, in this report, proving cure; SASA! moved IPV and concurrency by about 50% as the intended social outcome. A student who treats 'the cluster intervention worked' as one sentence will misread at least one of these papers.
- Supports · Did India’s toilet campaign improve child health?
- Supports · SASA! cut partner violence in Kampala
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