The use of digital technologies in adherence to anti-tuberculosis treatment.

Tuberculosis (TB) kills over 1.5 million people every year, particularly in low- and middle-income countries. Despite recent advances, regimens are at least several months in length, which can be problematic for people with TB. In the last decade, digital adherence technologies (DATs) have been used both to monitor and to promote dose taking. As interventions, DATs can be reminders for dose taking and generate digital dosing histories to help triage patients. The evidence for DATs improving treatment outcomes as a result of improving adherence is mixed. Emerging evidence suggests that people with TB value DAT functions that foster a feeling of being “cared for” by the health system. DATs should be embedded within, rather than used as the sole replacement for, comprehensive care packages. As monitors of dose taking, DATs provide rich dose-by-dose datasets for use in research and allow greater empowerment of people with TB than the directly observed therapy used previously. They may, however, not be a perfect proxy for adherence.