TB Treatment Support Tools: Refinement and Evaluation of an Interactive Mobile App and Direct Adherence Monitoring on TB Treatment Outcomes
2020 JAN 22 (NewsRx) -- By a
As a matter of record, on
Tracking Information
| Trial Identifier | NCT04221789 |
| First Submitted Date | |
| First Posted Date | |
| Results First Submitted Date | Not Provided |
| Results First Posted Date | Not Provided |
| Last Update Submitted Date | |
| Last Update Posted Date | |
| Primary Completion Date | |
| Start Date | |
| Current Primary Outcome Measures | •Treatment success [ Time Frame: 6 months ] -- Completion of treatment and or cure |
| •Treatment default [ Time Frame: 6 months ] -- Abandonment of treatment for at least 2 months | |
| Current Secondary Outcome Measures | Not Provided |
| Other Outcome Measures | Not Provided |
| Change History | Complete list of historical revisions of study NCT04221789 |
Descriptive Information
| Brief Title | TB Treatment Support Tool Interactive Mobile App and Direct Adherence Monitoring on TB Treatment Outcomes |
| Official Title | TB Treatment Support Tools: Refinement and Evaluation of an Interactive Mobile App and Direct Adherence Monitoring on TB Treatment Outcomes |
| Brief Summary | The overall goal of this study is to conduct a Randomized Clinical Trial (RCT) to evaluate a tuberculosis treatment support tool (TB-TST), a cellular phone app developed using user-centered design principles and a paper-based drug metabolite urine test strip modified for home use for testing the presence of isoniazid drug metabolites in urine to directly monitor adherence to treatment, to improve treatment outcomes for patients with TB receiving self-administered treatment (SAT). Poor medication adherence to TB regimens, along with challenges in monitoring patients and returning them to treatment, are important contributing factors to poor outcomes and the development of drug resistance. With advances and proliferation of mobile technology platforms, there is substantial interest in the possible use of mobile health (mHealth) interventions to address these challenges. Of the mHealth approaches under investigation for TB adherence monitoring, drug metabolite testing has been identified as the most promising, ethical, and accurate, and the least intrusive and stigmatizing strategy compared to other mobile solutions, yet its potential remains largely unexplored. Additionally, mobile applications (apps) may provide personalized treatment supervision, increase patients’ self-management and improve patient-provider communication by offering more advanced functionalities for patient support and monitoring. The existing version of the TB-TST app offers education on TB and its treatment, communication with a care-coordinator, tracks treatment adherence (both by self-reporting and direct metabolite test strip images), self-reports treatment side-effects, and retains patient’s “diary” notes. This proposal builds on preliminary work to: 1) Refine the TB-TST intervention based on pilot study findings and apply principles of user-centered design; 2) Evaluate the impact of the TB-TST on treatment outcomes compared to usual care; 3) Assess patient and provider perceptions of the facilitators and barriers to implementation of the TB-TST and synthesize lessons learned with stakeholders and policy makers. Primary outcome will be treatment success. Secondary outcomes will include: treatment default rates, self-reported adherence, technology use and usability. Findings have broader implications not only for TB adherence but disease management more generally and will improve our understanding of how to support patients facing challenging treatment regimens |
| Detailed Description | Tuberculosis remains one of the top ten causes of death globally despite it being largely curable. Patients face many challenges to adhere to treatment and mobile health (mHealth) interventions may address these challenges and support patients to complete their treatment. We will improve an interactive intervention based on the combined input from patients and TB experts and evaluate the intervention’s impact on treatment outcomes in a randomized clinical trial. Findings have broader implications not only for TB adherence but disease management more generally and will improve our understanding of how to support patients in challenging treatment regimens. |
| Study Type | Interventional |
| Study Phase | N/A |
| Study Design | Allocation: Randomized |
| Intervention Model: Parallel Assignment | |
| Primary Purpose: Treatment | |
| Masking: Single | |
| Masking Description: Data analysts will not be aware of group allocation | |
| Condition | Tuberculosis |
| Treatment Adherence | |
| Intervention | •Other: TB treatment assistant |
| phone app | |
| Study Arms | •Experimental: intervention: TB treatment assistant |
| Patients receiving instructions to use phone application | |
| Interventions: | |
| ⚬Other: TB treatment assistant | |
| Publications* | *Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline |
| All |
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| PubMed Link - DiStefano MJ, Schmidt H. mHealth for Tuberculosis Treatment Adherence: A Framework to Guide Ethical Planning, Implementation, and Evaluation. Glob Health Sci Pract. 2016 Jun 27;4(2):211-21. doi: 10.9745/GHSP-D-16-00018. Print 2016 Jun 20. | |
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Recruitment Information
| Recruitment Status | Not yet recruiting |
| Estimated Enrollment | 400 |
| Estimated Completion Date | |
| Primary Completion Date | |
| Eligibility | Inclusion Criteria: There is no planned exclusion of women or minorities. Participants will include men and women of all racial and ethnic backgrounds who meet the inclusion criteria. Participants who are Spanish-speaking will be actively recruited. It is estimated that the sample will have a larger number of men than women based on national reports of TB cases. In the recent TB country report, around 60% of cases were male and 40% were female.1 Per National Population Census (2010): 46.2% of the population of |
| Sex/Gender | Sexes Eligible for Study: All |
| Ages | 18 years to 60 years |
| No | |
| Contacts | Primary contact: Fernando A Rubinstein, MD MPH, +54 11 47778767, [email protected] |
| Backup contact: Sarah Iribarren, RN PhD, 206 543 5211, [email protected] | |
| Listed Location Countries | Not Provided |
| Removed Location Countries |
Administrative Information
| NCT Number | NCT04221789 |
| Other Study ID Numbers | 12112019 |
| Has Data Monitoring Committee | Yes |
| Not Provided | |
| Plan to Share Data | No |
| Plan to Share Data (IPD) Description | Not Provided |
| Collaborators | |
| Investigators | Principal Investigator: Fernando A Rubinstein, MD MPH, |
| Information Provided By | |
| Verification Date |
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