Conceptual design of an automatic monitoring and reporting tool for adherence to tuberculosis therapy in Kigali area

Abstract

Efforts to fight tuberculosis have been provided worldwide, monitoring framework has been developed for tuberculosis control in Rwanda but the aggregated data excludes the adherence rate. Paper based tool doesn’t provide alert mechanism to remind patients to adhere on medication. To ensure Direct Observed Treatment (DOT), patients are required to take medication face-face with health providers which interfere with work or travel time and lead to interruptions. Despite presence of Health Management Information System (HMIS), adherence data are not yet reported. The project aimed to suggest an automatic tool for capturing, reporting and monitoring of data on adherence to tuberculosis therapy. This study is qualitative in nature and multistage sampling was used. An in depth interview guide was used for 23 informants. Conceptual architectural design was presented using architectures with Microsoft office Visio 2007. 86% of informants highlighted familiarity as benefit of paper based tool while timely data accessibility, lack of analysis, data sharing and tedious works are its major barriers. 87% of informants proposed to use Short Message Service (SMS) for reporting adherence, reminding and alerting patients to take medication. Enabling patients using Video Direct Observed Treatment (VDOT) facilitates monitoring and foresees that distance wouldn’t be an obstacle to adherence. Future research must develop and evaluate the cost effectiveness and user acceptability of automatic tool.