Background

Tuberculosis (TB) is a largely curable disease, yet it remains one of the top ten causes of death globally. In response to known challenges to completing the long course of TB treatment, our study team developed the TB treatment support tools (TB-TSTs). The mobile application (app) is comprised of the following main components: 1) tracks treatment progress, 2) provides disease tailored information, 3) interactive communication between patients and treatment supporters, and 4) is linked with a direct adherence drug metabolite test.

Objective

The objective of this study was to analyze the interactive communication between the patients and the treatment supporter during the TB-TSTs pilot testing to identify issues and guide intervention refinement.

Methods

We used mixed methods to analyze the interactive communication data. The study was conducted at a pulmonary disease specialized hospital in Argentina. Of the 42 study participants enrolled in the pilot study, 21 were randomly assigned to use the TB-TSTs for 6-months during their TB treatment. The treatment supporter was a registered nurse from the regional level of the National TB program. We conducted thematic and content analysis of the messages in their original language, Spanish. We assessed the themes over time and by whom initiated the messages.

Results

There were 2561 individual messages sent between the participants and treatment supporter. We identified 19 main themes: 7 were participant and 12 were treatment supporter initiated. Participant themes included missed report rationale, arranging in-person meeting, intervention support, TB treatment progress, disease/treatment questions, side effects and additional support. Treatment supporter themes included missed report inquiry, arranging in-person meeting, introduction and instructions, check-in’s, positive reinforcement, treatment progress inquiry, test-strip issues, intervention orientation, initial side-effect check in, follow-up on side effects and photo quality issues. Messages and themes decreased over time with most occurring within the first 2 months of treatment.

Conclusions

Although there was a decrease in the number of messages and the theme types over the 6-month study participation, treatment adherence support remained needed throughout. Potential solutions are suggested for the main issues and recommendations are being used to guide refinement.

中文翻译：

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参与者参与结核病治疗支持工具干预的见解：交互式消息的主题分析以指导改进以更好地满足最终用户的需求

背景

结核病 (TB) 是一种基本上可以治愈的疾病，但它仍然是全球十大死因之一。为了应对完成长期结核病治疗的已知挑战，我们的研究团队开发了结核病治疗支持工具 (TB-TST)。移动应用程序 (app) 由以下主要组件组成：1) 跟踪治疗进度，2) 提供针对疾病的信息，3) 患者与治疗支持者之间的互动交流，以及 4) 与直接依从性药物代谢物测试相关联。

客观的

本研究的目的是分析 TB-TST 试点测试期间患者与治疗支持者之间的互动交流，以确定问题并指导干预措施的改进。

方法

我们使用混合方法来分析交互式通信数据。该研究在阿根廷的一家肺部疾病专科医院进行。在参加试点研究的 42 名研究参与者中，有 21 人被随机分配到在 TB 治疗期间使用 TB-TST 6 个月。治疗支持者是国家结核病项目地区一级的注册护士。我们对消息的原始语言（西班牙语）进行了主题和内容分析。随着时间的推移，我们评估了这些主题以及由谁发起了这些消息。

结果

参与者和治疗支持者之间发送了 2561 条个人信息。我们确定了 19 个主题：7 个是参与者，12 个是治疗支持者发起的。参与者主题包括漏报原因、安排面对面会议、干预支持、结核病治疗进展、疾病/治疗问题、副作用和额外支持。治疗支持者主题包括遗漏报告查询、安排面对面会议、介绍和说明、登记、积极强化、治疗进展查询、试纸问题、干预导向、初始副作用检查、副作用跟进和照片质量问题。消息和主题随着时间的推移而减少，大部分发生在治疗的前 2 个月内。

结论

尽管在为期 6 个月的研究参与中消息数量和主题类型有所减少，但始终需要治疗依从性支持。针对主要问题提出了潜在的解决方案，并使用建议来指导改进。