Bridging the Gap: Telemedicine and TB Treatment Adherence in India

Abstract

Objective: This article examines the progress made in utilizing telemedicine for the treatment of tuberculosis (TB), particularly in enhancing patient adherence to treatment regimens. In a case study, the review evaluates the Ni-Kshay platform for health professionals and patients in India, identifying pain points contributing to treatment defaults. It aligns these findings with the country's National TB Elimination Program (NTEP) and offers recommendations to enhance telemedicine's role in TB treatment adherence.

Methods: The Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) framework was used to identify articles from two databases: Web of Science, and PubMed. The literature search included terms such as Telemedicine, eHealth, mHEALTH, Digital Health, Mobile Health, Video DOT, along with Tuberculosis and TB. Articles published between January 2021 and June 2024 were selected for the review.

Results: Out of 948 initially retrieved articles, 94 were reviewed. Except one, all reported positive outcomes from telemedicine. Video DOT and video calls showed superior results among various technologies. Instant messaging apps and smart pillboxes are rising. Mobile app solutions are promising. Telemedicine serves as a complementary tool to in-person clinical supervision, enhancing rather than replacing traditional face-to-face oversight. Integrating successful external interventions by studying local utility and limitations is critical.

Conclusion: The utilization of telemedicine in TB treatment is increasing, highlighting the necessity for documenting best practices and establishing standardized protocols. However, the success of any technology-driven solution hinges on its alignment with user needs and contextual realities. In developing countries, it is crucial to deliberately and pragmatically integrate these solutions to effectively address challenges such as unequal access, high costs, social stigma, comorbidity prevalence, and delivery inefficiencies.