Digital adherence technologies for the management of tuberculosis therapy: landscape and research priorities

Please see this new paper in BMJ Global Health on digital adherence tools for TB.


PDF attached.
Subbaraman_BMJ_GH_2018_UvRRIqR.pdf (1.2 MB)

Yet more evidence that substantial cost savings is possible while also greatly improving the transparency and accountability of the healthcare system. And all while giving patients a more convenient, aka better, healthcare experience. Why is global health fixated on proving that digital adherence improves adherence? (not this article, but is the major criticism raised at every conference and funding table I’ve attended). Why isn’t it enough to know that you can get comparable adherence with a HUGE savings in cost and a BETTER patient experience?

With diagnostics, the corollary is donor obsession with specificity and sensitivity. Last time I was in an LMIC looking at their BD MGIT devices used for TB DST, all 8 MGITs in the country were broken and inoperable despite having an active maintenance contract in place. Not only that, but neither the NTP nor the vendor knew the instruments weren’t working. Who cares what the sensitivity is of a 300 pound paperweight?

There are many known gaps in healthcare and if a solution fixes 1 or 2 of them, that’s progress. Let’s stop measuring success by outdated “gold standards” and start practicing what we preach…“Evidence-based medicine” should lead to “Evidence-based funding” and programs.