A novel approach to monitoring adherence to preventive therapy for tuberculosis in adolescence

M Starr; S M Sawyer; J B Carlin; Cve Powell; R G Newman; Pdr Johnson

doi:10.1046/j.1440-1754.1999.00371.x

A novel approach to monitoring adherence to preventive therapy for tuberculosis in adolescence

J Paediatr Child Health. 1999 Aug;35(4):350-354. doi: 10.1046/j.1440-1754.1999.00371.x.

Authors

M Starr¹, S M Sawyer¹, J B Carlin¹, Cve Powell¹, R G Newman¹, Pdr Johnson¹

Affiliation

¹ Department of Microbiology and Infectious Diseases,,Centre for Adolescent Health,,Clinical Epidemiology and Biostatistics Unit,,Department of Thoracic Medicine,,Department of Biomedical Engineering, Royal Children's Hospital, Parkville, Victoria, Australia.

PMID: 28871640
DOI: 10.1046/j.1440-1754.1999.00371.x

Abstract

Objectives: To evaluate the usefulness of a microelectronic tablet-dispenser for monitoring adherence to preventive therapy for tuberculosis infection in adolescents.

Methodology: Twenty-one patients with positive Mantoux tests were treated with isoniazid (INH), dispensed in a microelectronic tablet-dispenser that recorded the date, time and duration that the container was opened. Other measures of adherence included attendance at clinic, patient self-report, tablet count, and measurement of urinary INH metabolites.

Results: The mean adherence rates were: 83% using attendance at clinic, 91% using tablet counts, 79% using urine assays, and 66% using the electronic tablet-dispenser. Self-reporting appeared to over-estimate adherence.

Conclusions: Adherence to 6 months of INH calculated using different measures is higher in this study than in previous reports. Microelectronic tablet-dispensers are an effective method to objectively measure adherence on a daily basis. Other measures are less helpful.

Keywords: adherence; child; drug monitoring; isoniazid; tuberculosis.