Several significant and positive changes with respect to adherence, adherence interventions, adherence technologies, and medication monitors in particular were included in the newly released WHO 2017 Update on Guidelines for DS-TB Treatment. These guidelines make several important points about the importance of TB treatment adherence, about the impact of various adherence interventions, and about the promising role of digital technologies in achieving improved treatment outcomes and reduced disease morbidity. Importantly, the guidelines contain the first-ever WHO evidence-based recommendations on the use of, among other approaches, digital medication monitors to help patients adhere to TB medication and deliver TB care. These guidelines and new recommendations represent a significant and positive step forward with respect to adherence interventions generally — acknowledging that some form of adherence intervention is, in essence, required in order to ensure good TB treatment outcomes. In addition, these guidelines make clear that that digital medication monitors such as the evriMED devices (www.wisepill.com) developed with support from the Bill & Melinda Gates Foundation, have been “approved for use” pursuant to these new guidelines.
Bruce was also recently named contributor in an abstract re 99DOTS for 2015 Union Lung Conference. The abstract discusses how 99DOTS empowers patients, providers, and treatment programs, supporting health system efficacy and efficiency. Adherent patients can take independent custody of their drugs and confirm consumption without physical observation, which simultaneously reduces the burden on providers. Program managers gain real-time information on adherence, enabling more customized and more efficient patient supervision and support. 99DOTS may be especially applicable as India switches from thrice-weekly to daily regimens, as it enables daily monitoring without daily observation.
Bruce has co-authored a manuscript (manuscript ID: ERJ-00424-2016) entitled “Digital health for the End TB Strategy: developing priority products and making them work” which has just been published in the July issue of European Respiratory Journal, and can be viewed online at: http://erj.ersjournals.com/lookup/doi/10.1183/13993003.00424-2016.
The paper outlines the approaches taken by the WHO Global Task Force on Digital Health for TB to advocate and support the development of digital health innovations in global efforts to improve TB care and prevention. The article also includes target product profiles, as developed by early 2016, defining nine priority digital health concepts and products that are strategically positioned to enhance TB action at the country level.