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Usability of a Medication Event Reminder Monitor System (MERM) by Providers and Patients to Improve Adherence in the Management of Tuberculosis

Author

Listed:
  • Xiaoqiu Liu

    (National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China)

  • Terrence Blaschke

    (Department of Medicine, Stanford University, Stanford, CA 94305, USA)

  • Bruce Thomas

    (The Arcady Group, Richmond, VA 23226, USA)

  • Sabina De Geest

    (Institute of Nursing Science, University of Basel, CH-4056 Basel, Switzerland)

  • Shiwen Jiang

    (National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China)

  • Yongxin Gao

    (National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China)

  • Xinxu Li

    (National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China)

  • Elizabeth Whalley Buono

    (The Arcady Group, Richmond, VA 23226, USA)

  • Stacy Buchanan

    (The Arcady Group, Richmond, VA 23226, USA)

  • Zhiying Zhang

    (PATH China Program, Beijing 100600, China)

  • Shitong Huan

    (Bill and Melinda Gates Foundation, Beijing 100027, China)

Abstract

Poor initiation and implementation and premature discontinuation of anti-tuberculous therapy, all forms of nonadherence, are major reasons for treatment failure, the development of drug-resistant tuberculosis, and transmission to other non-infected individuals. Directly Observed Therapy (DOT) has been the worldwide standard, but implementation of DOT is burdensome for providers and patients, especially in resource-limited settings, where most of the burden of active TB is located. Among the alternatives to DOT is electronic monitoring (EM) of drug dosing histories. Here we report a usability study of a newly-designed, modular electronic monitor product, called the MERM (Medication Event and Reminder Monitor), that is compatible with TB medication formats and supply chains in resource-limited settings. This study, done in a rural setting in China, showed that the use of the MERM for EM of TB medications was associated with a high degree of user performance, acceptability, and satisfaction among both TB patients and medical staff. Based on these data, EM is becoming the standard of care for drug-susceptible TB patients in China and scaled implementations in several other countries with high TB burden have begun. In addition, the MERM is being used in MDR-TB patients and in clinical trials involving patients with TB/HIV and latent TB.

Suggested Citation

  • Xiaoqiu Liu & Terrence Blaschke & Bruce Thomas & Sabina De Geest & Shiwen Jiang & Yongxin Gao & Xinxu Li & Elizabeth Whalley Buono & Stacy Buchanan & Zhiying Zhang & Shitong Huan, 2017. "Usability of a Medication Event Reminder Monitor System (MERM) by Providers and Patients to Improve Adherence in the Management of Tuberculosis," IJERPH, MDPI, vol. 14(10), pages 1-11, September.
  • Handle: RePEc:gam:jijerp:v:14:y:2017:i:10:p:1115-:d:113104
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    References listed on IDEAS

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    1. Salla A Munro & Simon A Lewin & Helen J Smith & Mark E Engel & Atle Fretheim & Jimmy Volmink, 2007. "Patient Adherence to Tuberculosis Treatment: A Systematic Review of Qualitative Research," PLOS Medicine, Public Library of Science, vol. 4(7), pages 1-16, July.
    2. Salla A Munro, 2007. "Patient Adherence to Tuberculosis Treatment: A Systematic Review of Qualitative Research," Working Papers id:1107, eSocialSciences.
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