Improving tuberculosis treatment adherence: a qualitative study of patients’ perspectives from a pragmatic trial of the tuberculosis treatment support tools intervention

Autores
Roberti, Javier Eugenio; Morelli, Daniela Moraes; Aguilar Vidrio, Omar Alfonso; Suyanto, Agnes; Carmiol Rodriguez, Priscilla; Tolentino, Alejandra; Chen Liang, Enrique; Sprecher, Jennifer; Rubinstein, Fernando Adrian; Iribarren, Sarah
Año de publicación
2025
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Objective: To explore patient perspectives on using a digital adherence technology (DAT) for tuberculosis (TB) treatment, specifically, the TB Treatment Support Tools (TB-TST) intervention, which integrates a mobile app designed to enhance patient-centred support, monitoring and communication, alongside a drug metabolite test.Design: Qualitative study conducted as part of a pragmatic randomised controlled trial.Setting and participants: Four public reference hospitals in Argentina. All patients in the intervention group were invited to participate; 33 patients in the intervention group and five treatment supporters were included.Data collection and analysis: semistructured interviews were conducted. The normalisation process theory guided analysis to understand factors that enable or hinder the intervention's integration into routine practice for TB treatment medication adherence.Results: Patients identified medication reminders, educational messages and direct communication with treatment supporters (TSs) as the most helpful components of the intervention. Many reported using the app to ask TSs questions they felt uncomfortable raising with physicians in person. Initially, many patients did not fully understand the purpose and use of the metabolite test. Over time, their understanding of the app improved, though some continued to misinterpret the test results. Motivation to adhere to TB treatment was primarily driven by a desire to protect family members and resume normal daily activities. Reported barriers to app use included time constraints due to work, technical issues, limited internet connectivity and the burden of medication side effects. While the intervention was generally perceived as supportive and user-friendly, patients suggested improvements such as faster response times from TSs, expanded availability and better technical reliability and internet access.Conclusion: These findings highlight the importance of tailoring digital adherence interventions to meet the diverse needs of patients and reinforce the pivotal role of the TS as a trusted and accessible source of guidance throughout TB treatment.
Fil: Roberti, Javier Eugenio. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
Fil: Morelli, Daniela Moraes. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Aguilar Vidrio, Omar Alfonso. University of Washington; Estados Unidos
Fil: Suyanto, Agnes. University of Washington; Estados Unidos
Fil: Carmiol Rodriguez, Priscilla. University of Washington; Estados Unidos
Fil: Tolentino, Alejandra. University of Washington; Estados Unidos
Fil: Chen Liang, Enrique. University of Washington; Estados Unidos
Fil: Sprecher, Jennifer. University of Washington; Estados Unidos
Fil: Rubinstein, Fernando Adrian. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Iribarren, Sarah. University of Washington; Estados Unidos
Materia
mHEALTH
ADHERENCE
TUBERCULOSIS
APPLICATION
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/291253
Acceder
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oai_identifier_str oai:ri.conicet.gov.ar:11336/291253
network_acronym_str CONICETDig
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network_name_str CONICET Digital (CONICET)
spelling Improving tuberculosis treatment adherence: a qualitative study of patients’ perspectives from a pragmatic trial of the tuberculosis treatment support tools interventionRoberti, Javier EugenioMorelli, Daniela MoraesAguilar Vidrio, Omar AlfonsoSuyanto, AgnesCarmiol Rodriguez, PriscillaTolentino, AlejandraChen Liang, EnriqueSprecher, JenniferRubinstein, Fernando AdrianIribarren, SarahmHEALTHADHERENCETUBERCULOSISAPPLICATIONhttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3Objective: To explore patient perspectives on using a digital adherence technology (DAT) for tuberculosis (TB) treatment, specifically, the TB Treatment Support Tools (TB-TST) intervention, which integrates a mobile app designed to enhance patient-centred support, monitoring and communication, alongside a drug metabolite test.Design: Qualitative study conducted as part of a pragmatic randomised controlled trial.Setting and participants: Four public reference hospitals in Argentina. All patients in the intervention group were invited to participate; 33 patients in the intervention group and five treatment supporters were included.Data collection and analysis: semistructured interviews were conducted. The normalisation process theory guided analysis to understand factors that enable or hinder the intervention's integration into routine practice for TB treatment medication adherence.Results: Patients identified medication reminders, educational messages and direct communication with treatment supporters (TSs) as the most helpful components of the intervention. Many reported using the app to ask TSs questions they felt uncomfortable raising with physicians in person. Initially, many patients did not fully understand the purpose and use of the metabolite test. Over time, their understanding of the app improved, though some continued to misinterpret the test results. Motivation to adhere to TB treatment was primarily driven by a desire to protect family members and resume normal daily activities. Reported barriers to app use included time constraints due to work, technical issues, limited internet connectivity and the burden of medication side effects. While the intervention was generally perceived as supportive and user-friendly, patients suggested improvements such as faster response times from TSs, expanded availability and better technical reliability and internet access.Conclusion: These findings highlight the importance of tailoring digital adherence interventions to meet the diverse needs of patients and reinforce the pivotal role of the TS as a trusted and accessible source of guidance throughout TB treatment.Fil: Roberti, Javier Eugenio. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Morelli, Daniela Moraes. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Aguilar Vidrio, Omar Alfonso. University of Washington; Estados UnidosFil: Suyanto, Agnes. University of Washington; Estados UnidosFil: Carmiol Rodriguez, Priscilla. University of Washington; Estados UnidosFil: Tolentino, Alejandra. University of Washington; Estados UnidosFil: Chen Liang, Enrique. University of Washington; Estados UnidosFil: Sprecher, Jennifer. University of Washington; Estados UnidosFil: Rubinstein, Fernando Adrian. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Iribarren, Sarah. University of Washington; Estados UnidosBMJ Publishing Group2025-09info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/291253Roberti, Javier Eugenio; Morelli, Daniela Moraes; Aguilar Vidrio, Omar Alfonso; Suyanto, Agnes; Carmiol Rodriguez, Priscilla; et al.; Improving tuberculosis treatment adherence: a qualitative study of patients’ perspectives from a pragmatic trial of the tuberculosis treatment support tools intervention; BMJ Publishing Group; BMJ Open; 15; 9; 9-2025; 1-102044-6055CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2024-095878info:eu-repo/semantics/altIdentifier/doi/10.1136/bmjopen-2024-095878info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2026-08-25T14:34:02Zoai:ri.conicet.gov.ar:11336/291253instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982026-08-25 14:34:02.617CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Improving tuberculosis treatment adherence: a qualitative study of patients’ perspectives from a pragmatic trial of the tuberculosis treatment support tools intervention
title Improving tuberculosis treatment adherence: a qualitative study of patients’ perspectives from a pragmatic trial of the tuberculosis treatment support tools intervention
spellingShingle Improving tuberculosis treatment adherence: a qualitative study of patients’ perspectives from a pragmatic trial of the tuberculosis treatment support tools intervention
Roberti, Javier Eugenio
mHEALTH
ADHERENCE
TUBERCULOSIS
APPLICATION
title_short Improving tuberculosis treatment adherence: a qualitative study of patients’ perspectives from a pragmatic trial of the tuberculosis treatment support tools intervention
title_full Improving tuberculosis treatment adherence: a qualitative study of patients’ perspectives from a pragmatic trial of the tuberculosis treatment support tools intervention
title_fullStr Improving tuberculosis treatment adherence: a qualitative study of patients’ perspectives from a pragmatic trial of the tuberculosis treatment support tools intervention
title_full_unstemmed Improving tuberculosis treatment adherence: a qualitative study of patients’ perspectives from a pragmatic trial of the tuberculosis treatment support tools intervention
title_sort Improving tuberculosis treatment adherence: a qualitative study of patients’ perspectives from a pragmatic trial of the tuberculosis treatment support tools intervention
dc.creator.none.fl_str_mv Roberti, Javier Eugenio
Morelli, Daniela Moraes
Aguilar Vidrio, Omar Alfonso
Suyanto, Agnes
Carmiol Rodriguez, Priscilla
Tolentino, Alejandra
Chen Liang, Enrique
Sprecher, Jennifer
Rubinstein, Fernando Adrian
Iribarren, Sarah
author Roberti, Javier Eugenio
author_facet Roberti, Javier Eugenio
Morelli, Daniela Moraes
Aguilar Vidrio, Omar Alfonso
Suyanto, Agnes
Carmiol Rodriguez, Priscilla
Tolentino, Alejandra
Chen Liang, Enrique
Sprecher, Jennifer
Rubinstein, Fernando Adrian
Iribarren, Sarah
author_role author
author2 Morelli, Daniela Moraes
Aguilar Vidrio, Omar Alfonso
Suyanto, Agnes
Carmiol Rodriguez, Priscilla
Tolentino, Alejandra
Chen Liang, Enrique
Sprecher, Jennifer
Rubinstein, Fernando Adrian
Iribarren, Sarah
author2_role author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv mHEALTH
ADHERENCE
TUBERCULOSIS
APPLICATION
topic mHEALTH
ADHERENCE
TUBERCULOSIS
APPLICATION
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.2
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Objective: To explore patient perspectives on using a digital adherence technology (DAT) for tuberculosis (TB) treatment, specifically, the TB Treatment Support Tools (TB-TST) intervention, which integrates a mobile app designed to enhance patient-centred support, monitoring and communication, alongside a drug metabolite test.Design: Qualitative study conducted as part of a pragmatic randomised controlled trial.Setting and participants: Four public reference hospitals in Argentina. All patients in the intervention group were invited to participate; 33 patients in the intervention group and five treatment supporters were included.Data collection and analysis: semistructured interviews were conducted. The normalisation process theory guided analysis to understand factors that enable or hinder the intervention's integration into routine practice for TB treatment medication adherence.Results: Patients identified medication reminders, educational messages and direct communication with treatment supporters (TSs) as the most helpful components of the intervention. Many reported using the app to ask TSs questions they felt uncomfortable raising with physicians in person. Initially, many patients did not fully understand the purpose and use of the metabolite test. Over time, their understanding of the app improved, though some continued to misinterpret the test results. Motivation to adhere to TB treatment was primarily driven by a desire to protect family members and resume normal daily activities. Reported barriers to app use included time constraints due to work, technical issues, limited internet connectivity and the burden of medication side effects. While the intervention was generally perceived as supportive and user-friendly, patients suggested improvements such as faster response times from TSs, expanded availability and better technical reliability and internet access.Conclusion: These findings highlight the importance of tailoring digital adherence interventions to meet the diverse needs of patients and reinforce the pivotal role of the TS as a trusted and accessible source of guidance throughout TB treatment.
Fil: Roberti, Javier Eugenio. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
Fil: Morelli, Daniela Moraes. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Aguilar Vidrio, Omar Alfonso. University of Washington; Estados Unidos
Fil: Suyanto, Agnes. University of Washington; Estados Unidos
Fil: Carmiol Rodriguez, Priscilla. University of Washington; Estados Unidos
Fil: Tolentino, Alejandra. University of Washington; Estados Unidos
Fil: Chen Liang, Enrique. University of Washington; Estados Unidos
Fil: Sprecher, Jennifer. University of Washington; Estados Unidos
Fil: Rubinstein, Fernando Adrian. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Iribarren, Sarah. University of Washington; Estados Unidos
description Objective: To explore patient perspectives on using a digital adherence technology (DAT) for tuberculosis (TB) treatment, specifically, the TB Treatment Support Tools (TB-TST) intervention, which integrates a mobile app designed to enhance patient-centred support, monitoring and communication, alongside a drug metabolite test.Design: Qualitative study conducted as part of a pragmatic randomised controlled trial.Setting and participants: Four public reference hospitals in Argentina. All patients in the intervention group were invited to participate; 33 patients in the intervention group and five treatment supporters were included.Data collection and analysis: semistructured interviews were conducted. The normalisation process theory guided analysis to understand factors that enable or hinder the intervention's integration into routine practice for TB treatment medication adherence.Results: Patients identified medication reminders, educational messages and direct communication with treatment supporters (TSs) as the most helpful components of the intervention. Many reported using the app to ask TSs questions they felt uncomfortable raising with physicians in person. Initially, many patients did not fully understand the purpose and use of the metabolite test. Over time, their understanding of the app improved, though some continued to misinterpret the test results. Motivation to adhere to TB treatment was primarily driven by a desire to protect family members and resume normal daily activities. Reported barriers to app use included time constraints due to work, technical issues, limited internet connectivity and the burden of medication side effects. While the intervention was generally perceived as supportive and user-friendly, patients suggested improvements such as faster response times from TSs, expanded availability and better technical reliability and internet access.Conclusion: These findings highlight the importance of tailoring digital adherence interventions to meet the diverse needs of patients and reinforce the pivotal role of the TS as a trusted and accessible source of guidance throughout TB treatment.
publishDate 2025
dc.date.none.fl_str_mv 2025-09
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/291253
Roberti, Javier Eugenio; Morelli, Daniela Moraes; Aguilar Vidrio, Omar Alfonso; Suyanto, Agnes; Carmiol Rodriguez, Priscilla; et al.; Improving tuberculosis treatment adherence: a qualitative study of patients’ perspectives from a pragmatic trial of the tuberculosis treatment support tools intervention; BMJ Publishing Group; BMJ Open; 15; 9; 9-2025; 1-10
2044-6055
CONICET Digital
CONICET
url http://hdl.handle.net/11336/291253
identifier_str_mv Roberti, Javier Eugenio; Morelli, Daniela Moraes; Aguilar Vidrio, Omar Alfonso; Suyanto, Agnes; Carmiol Rodriguez, Priscilla; et al.; Improving tuberculosis treatment adherence: a qualitative study of patients’ perspectives from a pragmatic trial of the tuberculosis treatment support tools intervention; BMJ Publishing Group; BMJ Open; 15; 9; 9-2025; 1-10
2044-6055
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2024-095878
info:eu-repo/semantics/altIdentifier/doi/10.1136/bmjopen-2024-095878
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv BMJ Publishing Group
publisher.none.fl_str_mv BMJ Publishing Group
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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score 13.24418

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