Implementation research on efficacy of pill-in-hand adherence monitoring
Bill and Melinda Gates Foundation
World Health Partners
Background
TB patients require 6-months long intensive treatment to cure the disease. However, non-adherence to treatment or irregular adherence are common, leading to increased risk of drug resistance, disease relapse and mortality among the patients. Indian launched the Integrated Digital Adherence Technology Initiative (IDAT) in 2019 which has delivered promising coverage of Digital Adherence Technologies (DATs) but barriers relating to health systems, health workers and patients need to be overcome for an optimal impact. Moreover, expansion of DATs is largely focussed on the public sector but integration of the private sector in this fold can have favourable outcomes for disease management and control.
About the Study
The study aims to evaluate three adherence monitoring methods from healthcare workers and patients’ perspective against the standard of care in private sector to:
i) Quantify the impact of these monitoring methods on patients’ medication adherence and clinical outcomes
ii) Identify the underlying mechanisms and pathways (“the how”) of the impact of these monitoring methods
iii) Optimise the effect of these monitoring methods on the workflow processes of frontline workers
iv) Estimate the programmatic costs of their implementation and scale-up.
Methodology
A mixed methods approach will be employed, wherein a Randomized Controlled Trial along with economics and behavioural science approach will be used to meet the study objectives.
Intended Outcome
The study aims to generate rigorous evidence to support policy decisions vis-a-vis the national level scale up of digital adherence management and implementation protocols while also assessing their cost effectiveness and budget impact.