Abstract:

Objective To compare conventional way of directly observed short course chemotherapy (DOTS) method and DOTS using mobile communication, to evaluate the effectiveness of TB treatment supervision under DOTS with mobile communication and to provide scientific evidence for tuberculosis control strategy development.Methods one hundred and seventy-four cases diagnosed with tuberculosis in TB control institutions and designated hospitals in Guangdong Province from January 2018 to June 2018, were randomly allocated to two groups according to the order of diagnosis using random number table. Eighty-nine cases were enrolled in conventional DOTS group and supervised following the guideline of China’s TB control program (Edition 2008); 85 cases were enrolled in the mobile communication DOTS group which adopted TB mobile communication DOTS management system to conduct the whole-course and standardized supervision. Data of those two groups were collected, regularity of drug taking, treatment outcome, status of supervision and follow-up under different DOTS models were analyzed.Results In terms of treatment compliance and outcome, the regular medication rate in mobile communication group was 97.6% (83/85), which was significantly higher than the conventional DOTS group 87.6% (78/89) (χ²=6.297,P<0.05). The median (quartile1 and quartile 3) gap time from adverse drug reactions onset to getting treated in conventional DOTS group was 6 (5,7) d, while in mobile communication DOTS group was 3 (2,4) d. The difference between those two groups was statistically significant (Z=-5.643, P<0.01). In terms of supervision and follow-up management, the supervision management rates of both groups were 100.0%. The regular supervision rate of conventional DOTS group was 88.8% (79/89), which was lower than the mobile communication DOTS group’s 92.9% (79/85), but it did not achieve statistical significance (χ²=0.909,P>0.05). The completion rate of follow-up in the intensive and consolidated phases of the mobile DOTS group were both 100.0%, compared with 98.9% (88/89) and 97.8% (87/89) in the conventional DOTS group (intensive phase:χ²=0.000, P>0.05;consolidated phase:χ²=0.461, P>0.05).Conclusion TB mobile communication DOTS management system provides comprehensive, continuous and proactive management service, which can effectively improve the regular medication rate of patients, shorten the delay for adverse drug reactions treatment and strengthen management of regular follow-up.

Key words: Tuberculosis,pulmonary, Drug therapy, Case management, Computer communication networks, Directly observed treatment short course chemotherapy, Comparative study, Outcome and process assessment (health care)