Patient experiences and motivations in tuberculosis treatment: Insights from a digital adherence technology trial

Abstract

Non-adherence to Tuberculosis (TB) treatment remains a global health challenge, particularly in low- and middle-income countries. Digital Adherence Technologies (DATs) have shown promise in improving treatment outcomes, yet little is known about user perceptions. Through an exit survey, this study evaluated the acceptability to participants of the Tuberculosis Treatment Support Tools intervention, which combines a mobile app for reporting of medication, direct contact with healthcare team, and a metabolite test to support self-administered TB treatment in Argentina. A pragmatic clinical trial was conducted at four public hospitals in Buenos Aires, in which 80 participants completed exit surveys. The app was rated highly for ease of use (4.3/5) and was strongly recommended to others (4.7/5). Features like medication reminders, direct messaging with treatment supporters, and an anonymous patient forum were praised for enhancing adherence and reducing isolation. The metabolite test, generally well-received, faced minor usability challenges. Participants highlighted need for simplified reporting and improved reminders. Motivation for adherence stemmed from health improvement goals, family support, and professional guidance. Recommendations for improvement included personalized features and addressing technical barriers. The intervention demonstrates potential for enhancing adherence by meeting practical and emotional needs, offering insights for the refinement of digital tools in TB treatment care.