PDF(Pubmed)
Abstract：
High-quality medication compliance is critical for the cure of pulmonary tuberculosis (PTB); however, the implementation of directly observed treatment (DOT) under direct interview still faces huge difficulties. Assessment of the effect of digital tool during community management has not been performed in eastern China.
All drug-sensitive PTB cases notified in Yiwu city from June to December 2020 were divided into the routine group and digital tool group based on patients\' willingness. The variables influencing the on-time completion level of home visits, medication adherence and treatment outcomes were estimated.
A total of 599 eligible patients were enrolled, with 268 participating in the routine group and 331 using a digital tool. Most participants were men (n = 357, 59.6%), and nearly all were new cases (n = 563, 94.0%). Participants\' mean age was 44.22 ± 20.32 years. There were significant differences in age, diagnostic type, and source of patients between the two groups. During the study period, the digital tool group had a higher on-time completion rate of home visits (91.5% vs. 82.5%) and medication adherence rate (94.3% vs. 89.6%) than the routine group, whereas there was no significant difference in the treatment success rate between the two groups (91.2% vs. 86.8%). Multivariate logistic regression analysis demonstrated that the digital tool group showed a more positive function in the on-time completion status of home visits, with an adjusted odds ratio of 0.41 (95% confidence interval: 0.25-0.70).
Digital tools can be employed to improve the on-time completion rate of home visits in Yiwu city. Further large-scale studies that use digital tools for community management are warranted.
All drug-sensitive PTB cases notified in Yiwu city from June to December 2020 were divided into the routine group and digital tool group based on patients\' willingness. The variables influencing the on-time completion level of home visits, medication adherence and treatment outcomes were estimated.
A total of 599 eligible patients were enrolled, with 268 participating in the routine group and 331 using a digital tool. Most participants were men (n = 357, 59.6%), and nearly all were new cases (n = 563, 94.0%). Participants\' mean age was 44.22 ± 20.32 years. There were significant differences in age, diagnostic type, and source of patients between the two groups. During the study period, the digital tool group had a higher on-time completion rate of home visits (91.5% vs. 82.5%) and medication adherence rate (94.3% vs. 89.6%) than the routine group, whereas there was no significant difference in the treatment success rate between the two groups (91.2% vs. 86.8%). Multivariate logistic regression analysis demonstrated that the digital tool group showed a more positive function in the on-time completion status of home visits, with an adjusted odds ratio of 0.41 (95% confidence interval: 0.25-0.70).
Digital tools can be employed to improve the on-time completion rate of home visits in Yiwu city. Further large-scale studies that use digital tools for community management are warranted.
摘要：
■高质量的药物依从性对于肺结核（PTB）的治愈至关重要；然而，在直接访谈下实施直接观察治疗(DOT)仍然面临巨大困难。华东地区尚未对数字工具在社区管理中的效果进行评估。
■将义乌市2020年6-12月通报的所有药敏PTB病例按患者意愿分为常规组和数字化工具组。影响家访按时完成水平的变量，对药物依从性和治疗结局进行了估计.
■共纳入599名符合条件的患者，268人参加例行小组，331人使用数字工具。大多数参与者是男性（n=357，59.6％），几乎所有病例都是新病例（n=563，94.0%）。参与者的平均年龄为44.22±20.32岁。年龄差异显著,诊断类型,两组患者的来源。在学习期间,数字工具组的家访按时完成率较高(91.5%vs.82.5%）和药物依从性（94.3%vs.89.6%)比常规组,而两组治疗成功率无显著差异(91.2%vs.86.8%）。多因素logistic回归分析显示,数字工具组对家访的按时完成状态表现出更积极的作用,调整后的比值比为0.41（95%置信区间：0.25-0.70）。
■可以使用数字工具来提高义乌市家访的按时完成率。使用数字工具进行社区管理的进一步大规模研究是必要的。
■将义乌市2020年6-12月通报的所有药敏PTB病例按患者意愿分为常规组和数字化工具组。影响家访按时完成水平的变量，对药物依从性和治疗结局进行了估计.
■共纳入599名符合条件的患者，268人参加例行小组，331人使用数字工具。大多数参与者是男性（n=357，59.6％），几乎所有病例都是新病例（n=563，94.0%）。参与者的平均年龄为44.22±20.32岁。年龄差异显著,诊断类型,两组患者的来源。在学习期间,数字工具组的家访按时完成率较高(91.5%vs.82.5%）和药物依从性（94.3%vs.89.6%)比常规组,而两组治疗成功率无显著差异(91.2%vs.86.8%）。多因素logistic回归分析显示,数字工具组对家访的按时完成状态表现出更积极的作用,调整后的比值比为0.41（95%置信区间：0.25-0.70）。
■可以使用数字工具来提高义乌市家访的按时完成率。使用数字工具进行社区管理的进一步大规模研究是必要的。
