One of the recognised issues in successful tuberculosis (TB) care is ensuring patient adherence to treatment regimens. A team at ASPAT-Peru (a TB treatment and support facility, based in Lima) is using the latest technology to strengthen treatment adherence and ensure patients are supported while undergoing TB treatment programmes.
The treatment management system - "SIAT-TB”* - is the first of its kind to focus on treatment adherence. The system uses unique software, developed by ASPAT, which allows real-time monitoring of people affected by TB who receive their treatment in individual healthcare centres throughout Lima.
The system began its testing phase in January 2017 in 30 centres. During this period, the rate of ‘loss of adherence’ reduced from 11 percent to 6 percent. As a result, the system is now being rolled-out in 76 health facilities throughout Lima, with an agreement in place with the Health Ministry to extend the scheme throughout Peru.
The system relies on an electronic database register for each patient undergoing TB treatment. An electronic treatment card records medication and dosage, and a system of biometric scanners enables patients to register their attendance at a clinic via their fingerprints. All data is recorded in real-time and the software operates a system of alerts through text messaging. These remind patients when to attend the health centre and immediately flag to staff the non-attendance of patients. If a patient does not attend a scheduled appointment, they are sent motivating messages such as “You can still make it to the healthcare centre to take your treatment”, rather than any language that might suggest blame. Not only does the system aim to reduce stigma, cases do not languish or disappear for weeks because any hint of non-adherence is picked up immediately.
Robert Popi is ASPAT-Peru’s Technology Officer and has guided the system through its development and testing phases. “My role at ASPAT is to develop technological innovation that improves the treatment of TB and create systems that make it possible to obtain data in real-time.”
He adds, “Technology is advancing and the healthcare sector can’t lag behind. Smart information makes it possible to exploit details on health and TB to make better decisions, which ultimately benefit the patients.”
Melecio Mayta, Executive Director, ASPAT-Peru, says: “Monitoring and enhancing treatment adherence is vital to safeguarding both individual and public health. One of the main problems in Peru is non-adherence to treatment. In Peru, 32 percent of TB patients have multidrug-resistant TB. In Lima, this is higher, between 50 and 100 percent. This system means that we don’t lose adherence and that we know the status of our patients at any given time.”
*SIAT-TB - Sistema Integral de Administración al Tratamiento de la Tuberculosis (Comprehensive Management System for Tuberculosis Treatment)
Read about the work of ASPAT-Peru
Notes:
The Union works closely with partners and stakeholders around the world to raise critical awareness of the multiple issues associated with TB and its drug-resistant versions. This story resulted from a Union-organised media and content gathering trip to Peru to highlight issues relating to TB in the region.
Ensuring treatment adherence is a key component of the World Health Organization’s (WHO) End TB Strategy which emphasises supportive treatment supervision to help patients take medication regularly and complete treatment, facilitating their cure and preventing drug resistance development. The strategy underlines the importance of supervision being carried out in a patient-sensitive manner and acknowledges the many barriers to adherence including education, emotional and material needs, stigmatisation and discrimination, and health system factors.
Photo by Javier Galeano