Analysis of using electronic pillbox to assist the medication management of pulmonary tuberculosis patients

doi:10.3969/j.issn.1000-6621.2020.07.008

Abstract

Abstract:

We analyzed the implementation result of using electronic pillbox to assist the medication management for people with pulmonary tuberculosis (PTB) in Jilin, Zhejiang and Ningxia among July 2018 to March 2019. Of 22229 patients, 14657 used electronic pillbox, the rate of electronic pillbox using in the third quarter of 2018 was 57.9% (2138/3695), but 78.9% (4774/6071) in the second quarter of 2019. During the treatment process, the uptake rate of pillbox decreased by month, 95.3% (13965/14659) at the end of second month and 85.0% (12454/14659) at the end of six month. 72.5% (10622/14659) of the patients using pillbox had adherence medication records, of which the adherence medication rate was 82.3% (8746/10622). The results of this study further proved the feasibility for implementing the new method of patient management, and provide implementation experience for the further scale up of electronic pillbox in China.

Key words: Tuberculosis, pulmonary, Drug therapy, Case management, outcome assessment (health care), Electronic health records, Medicine monitor

WANG Ni, ZHANG Hui, ZHANG Tie-juan, CHEN Bin, LEI Juan, SUN Miao-miao, HUANG Fei. Analysis of using electronic pillbox to assist the medication management of pulmonary tuberculosis patients[J]. Chinese Journal of Antituberculosis, 2020, 42(7): 682-686. doi: 10.3969/j.issn.1000-6621.2020.07.008

Figures/Tables 4

References 16

[1]	World Health Organizationg. Global tuberculosis report 2019. Geneva:World Health Organization, 2019.
[2]	Tesfahuneygn G, Medhin G, Legesse M. Adherence to Anti-tuberculosis treatment and treatment outcomes among tuberculosis patients in Alamata District, northeast Ethiopia. BMC Res Notes, 2015,8:503. doi: 10.1186/s13104-015-1452-x.
[3]	World Health Organization. Guidelines for treatment of drug-susceptible tuberculosis and patient care. Geneva: World Health Organization, 2017.
[4]	Hou WL, Song FJ, Zhang NX, et al. Implementation and community involvement in DOTS strategy: a systematic review of studies in China. Int J Tuberc Lung Dis, 2012,16:1433-1440. doi: 10.5588/ijtld.12.0080.
[5]	World Health Organization. Handbook for the use of digital technologies to support tuberculosis medication adherence. Geneva: World Health Organization, 2017.
[6]	Liu X, Lewis JJ, Zhang H, et al. Effectiveness of Electronic Reminders to Improve Medication Adherence in Tuberculosis Patients: A Cluster-Randomized Trial. PLoS Med, 2015,12:e1001876. doi: 10.1371/journal.pmed.1001876.
[7]	桓世彤, 陈嵘, 刘小秋, 等. 电子药盒取药记录监测肺结核患者服药行为的可行性评估. 中国防痨杂志, 2012,34(7):419-424.
[8]	Liu X, Blaschke T, Thomas B, et al. Usability of a Medication Event Reminder Monitor System (MERM) by Providers and Patients to Improve Adherence in the Management of Tuberculosis. Int J Env Res Public Heal, 2017,14: pii: E1115. doi: 10.3390/ijerph14101115.
[9]	Wang N, Zhang H, Zhou Y, et al. Using electronic medication monitoring to guide differential management of tuberculosis patients at the community level in China. BMC Infect Dis, 2019,19:844. doi: 10.1186/s12879-019-4521-2.
[10]	李智, 周惠, 陈晓军, 等. 基于数字技术的结核病患者管理方法研究进展. 中国防痨杂志, 2019,41(9):1015-1020. doi: 10.3969/j.issn.1000-6621.2019.09.019.
[11]	Vrijens B, Urquhart J, White D. Electronically monitored dosing histories can be used to develop a medication-taking habit and manage patient adherence. Expert Rev Clin Pharmacol, 2014,7:633-644. doi: 10.1586/17512433.2014.940896.
[12]	Xu W, Lu W, Zhou Y, et al. Adherence to anti-tuberculosis treatment among pulmonary tuberculosis patients: a qualitative and quantitative study. BMC Heal Serv Res, 2009,9:169. doi: 10.1186/1472-6963-9-169.
[13]	Yao S, Huang WH, van den Hof S, et al. Treatment adherence among sputum smear-positive pulmonary tuberculosis patients in mountainous areas in China. BMC Health Serv Res, 2011,11:341. doi: 10.1186/1472-6963-11-341.
[14]	Xu M, Markström U, Lyu J, et al. Detection of Low Adherence in Rural Tuberculosis Patients in China: Application of Morisky Medication Adherence Scale. Int J Environ Res Public Health, 2017,11:E248. doi: 10.3390/ijerph14030248.
[15]	Demonceau J, Ruppar T, Kristanto P, et al. Identification and assessment of adherence-enhancing interventions in studies assessing medication adherence through electronically compiled drug dosing histories: a systematic literature review and meta-analysis. Drugs, 2013,73:545-562. doi: 10.1007/s40265-013-0041-3.
[16]	Thakkar D, Piparva KG, Lakkad SG. A pilot project: 99DOTS information communication technology-based approach for tuberculosis treatment in Rajkot district. Lung India, 2019,36(2):108-111. doi: 10.4103/lungindia.lungindia_86_18.

地区	例数	男		女		0~岁		40~岁		65~岁
地区	例数	例数	构成比(%)	例数	构成比(%)	例数	构成比(%)	例数	构成比(%)	例数	构成比(%)
吉林	4478	3174	70.9	1304	29.1	1261	28.2	2295	51.2	922	20.6
浙江	8947	6039	67.5	2908	32.5	3423	38.2	3210	35.9	2314	25.9
宁夏	1234	677	54.9	557	45.1	418	33.9	385	31.2	431	34.9
合计	14659	9890	67.5	4769	32.5	5102	34.8	5890	40.2	3667	25.0

时间	吉林省			浙江省			宁夏回族自治区
时间	登记患者例数	使用药盒例数	使用率 (%)	登记患者例数	使用药盒例数	使用率 (%)	登记患者例数	使用药盒例数	使用率 (%)
2018年3季度	1318	508	38.5	2180	1478	67.8	197	152	77.2
2018年4季度	1950	1065	54.6	3464	2633	76.0	344	229	66.6
2019年1季度	2372	1293	54.5	3824	2157	56.4	509	370	72.7
2019年2季度	1805	1612	89.3	3783	2679	70.8	483	483	100.0
合计	7445	4478	60.1	13251	8947	67.5	1533	1234	80.5

地区	疗程开始		疗程1个月		疗程2个月		疗程3个月		疗程4个月		疗程5个月		疗程6个月
地区	例数	使用率 (%)	例数	使用率 (%)	例数	使用率 (%)	例数	使用率 (%)	例数	使用率 (%)	例数	使用率 (%)	例数	使用率 (%)
吉林	4478	100.0	4395	98.1	4240	94.7	4074	91.0	3919	87.5	3704	82.7	3490	77.9
浙江	8947	100.0	8779	98.1	8592	96.0	8420	94.1	8266	92.4	8156	91.2	8091	90.4
宁夏	1234	100.0	1184	95.9	1133	91.8	1070	86.7	1009	81.8	934	75.7	873	70.7
合计	14659	100.0	14358	97.9	13965	95.3	13564	92.5	13194	90.0	12794	87.3	12454	85.0