Enhancing tuberculosis treatment support: A thematic analysis of interactive messages in a digital adherence technology trial to identify needs, challenges, and strategies for improvement.

<h4>Background</h4>Digital adherence technologies (DATs) offer promising solutions for monitoring and supporting adherence to complex treatment regimens, including tuberculosis (TB) treatment. However, better understanding is needed of how users engage with DATs and how engagement influe...

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Main Authors: Javier Roberti, Priscilla Carmiol-Rodríguez, Enrique Chan-Liang, Omar Alfonso Aguilar-Vidrio, Agnes A Suyanto, Jennifer Sprecher, Fernando Rubinstein, Sarah Iribarren
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0326492
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author Javier Roberti
Priscilla Carmiol-Rodríguez
Enrique Chan-Liang
Omar Alfonso Aguilar-Vidrio
Agnes A Suyanto
Jennifer Sprecher
Fernando Rubinstein
Sarah Iribarren
author_facet Javier Roberti
Priscilla Carmiol-Rodríguez
Enrique Chan-Liang
Omar Alfonso Aguilar-Vidrio
Agnes A Suyanto
Jennifer Sprecher
Fernando Rubinstein
Sarah Iribarren
author_sort Javier Roberti
collection DOAJ
description <h4>Background</h4>Digital adherence technologies (DATs) offer promising solutions for monitoring and supporting adherence to complex treatment regimens, including tuberculosis (TB) treatment. However, better understanding is needed of how users engage with DATs and how engagement influences their effectiveness, particularly in real-world settings and among underserved populations.<h4>Objective</h4>Assess user engagement with the Companion app within the Tuberculosis Treatment Support Tools (TB-TST) intervention and explore the types of interactions that promote treatment adherence and address patients' needs.<h4>Methods</h4>Secure message threads (N = 255) were analyzed as part of a four-site pragmatic clinical trial evaluating the effectiveness of the TB-TST intervention. Pragmatic thematic analysis was applied to chat logs between patients and treatment supporters (TSs) to identify key themes related to application utilization, treatment adherence, technical challenges, and communication patterns.<h4>Results</h4>Key themes that emerged included: experiences of living with TB; COVID-19 pandemic impact; symptom guidance, healthcare coordination, and treatment and intervention adherence and technical issues. Patients frequently sought advice on how to integrate TB treatment into their daily lives, manage side effects, and cope with emotional distress. The communication styles of TSs varied, with personalized and empathetic interactions leading to better patient acceptance. Technical issues and difficulties accessing phone credit and connectivity challenges were barriers to intervention adherence. Recommendations from this analysis emphasize the need for personalized communication, streamlined adherence reporting, timely symptom guidance, expanded mental health support, and improved healthcare coordination to strengthen the intervention.<h4>Conclusion</h4>This study highlights the importance of personalized, empathetic communication, and reliable technology to enhance the effectiveness of DATs. Future DAT solutions should prioritize technological reliability and the human elements of care. Interventions must be adaptable, user-friendly, and capable of addressing diverse patient needs, including offering emotional support and empowering individuals with limited digital literacy.
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spelling doaj-art-789ba9b9c01c4d3aad162b2ca2ff3e5d2025-08-20T04:00:40ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01207e032649210.1371/journal.pone.0326492Enhancing tuberculosis treatment support: A thematic analysis of interactive messages in a digital adherence technology trial to identify needs, challenges, and strategies for improvement.Javier RobertiPriscilla Carmiol-RodríguezEnrique Chan-LiangOmar Alfonso Aguilar-VidrioAgnes A SuyantoJennifer SprecherFernando RubinsteinSarah Iribarren<h4>Background</h4>Digital adherence technologies (DATs) offer promising solutions for monitoring and supporting adherence to complex treatment regimens, including tuberculosis (TB) treatment. However, better understanding is needed of how users engage with DATs and how engagement influences their effectiveness, particularly in real-world settings and among underserved populations.<h4>Objective</h4>Assess user engagement with the Companion app within the Tuberculosis Treatment Support Tools (TB-TST) intervention and explore the types of interactions that promote treatment adherence and address patients' needs.<h4>Methods</h4>Secure message threads (N = 255) were analyzed as part of a four-site pragmatic clinical trial evaluating the effectiveness of the TB-TST intervention. Pragmatic thematic analysis was applied to chat logs between patients and treatment supporters (TSs) to identify key themes related to application utilization, treatment adherence, technical challenges, and communication patterns.<h4>Results</h4>Key themes that emerged included: experiences of living with TB; COVID-19 pandemic impact; symptom guidance, healthcare coordination, and treatment and intervention adherence and technical issues. Patients frequently sought advice on how to integrate TB treatment into their daily lives, manage side effects, and cope with emotional distress. The communication styles of TSs varied, with personalized and empathetic interactions leading to better patient acceptance. Technical issues and difficulties accessing phone credit and connectivity challenges were barriers to intervention adherence. Recommendations from this analysis emphasize the need for personalized communication, streamlined adherence reporting, timely symptom guidance, expanded mental health support, and improved healthcare coordination to strengthen the intervention.<h4>Conclusion</h4>This study highlights the importance of personalized, empathetic communication, and reliable technology to enhance the effectiveness of DATs. Future DAT solutions should prioritize technological reliability and the human elements of care. Interventions must be adaptable, user-friendly, and capable of addressing diverse patient needs, including offering emotional support and empowering individuals with limited digital literacy.https://doi.org/10.1371/journal.pone.0326492
spellingShingle Javier Roberti
Priscilla Carmiol-Rodríguez
Enrique Chan-Liang
Omar Alfonso Aguilar-Vidrio
Agnes A Suyanto
Jennifer Sprecher
Fernando Rubinstein
Sarah Iribarren
Enhancing tuberculosis treatment support: A thematic analysis of interactive messages in a digital adherence technology trial to identify needs, challenges, and strategies for improvement.
PLoS ONE
title Enhancing tuberculosis treatment support: A thematic analysis of interactive messages in a digital adherence technology trial to identify needs, challenges, and strategies for improvement.
title_full Enhancing tuberculosis treatment support: A thematic analysis of interactive messages in a digital adherence technology trial to identify needs, challenges, and strategies for improvement.
title_fullStr Enhancing tuberculosis treatment support: A thematic analysis of interactive messages in a digital adherence technology trial to identify needs, challenges, and strategies for improvement.
title_full_unstemmed Enhancing tuberculosis treatment support: A thematic analysis of interactive messages in a digital adherence technology trial to identify needs, challenges, and strategies for improvement.
title_short Enhancing tuberculosis treatment support: A thematic analysis of interactive messages in a digital adherence technology trial to identify needs, challenges, and strategies for improvement.
title_sort enhancing tuberculosis treatment support a thematic analysis of interactive messages in a digital adherence technology trial to identify needs challenges and strategies for improvement
url https://doi.org/10.1371/journal.pone.0326492
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