Latent Tuberculosis Infection Clinical Trial
Official title:
The Effect of Weekly Text-message Communication on Treatment Completion Among Patients With Latent Tuberculosis Infection: a Randomised Controlled Trial (WelTel LTBI)
This study will examine the impact of use of mobile phones and text messaging on adherence
to treatment for patients with latent TB infection. Half (50%) of the 350 anticipated study
participants will receive weekly text messages inquiring on their health status in relation
to their prescribed treatment, while the other half (50%) will not receive weekly text
messages at all. Medical adherence will be assessed by monthly blood-work, clinic visits and
by interviewing patients at each of these visits.
The investigators hypothesis is that enhanced communication with a health care provider, via
a structured cell phone SMS text messaging based program (WelTel), will result in a 15%
improvement in the proportion of patients who successfully complete their LTBI treatment
regimens.
1. Purpose
The purpose of this study is to compare the proportion of patients who are adherent to
their TB medications among those receiving weekly text messages plus standard of care
and those who receive standard of care only.
2. Justification:
Previous research has shown that weekly text messages from a health care provider
increases medication adherence for HIV patients. The investigators would like to
determine if a similar effect in terms of adherence can be seen in patients receiving
medication for latent tuberculosis infection
3. Objectives
Primary Objective:
1) To compare successful treatment completion rates for patients treated with 9 months of
INH or 4 months of RIF between those receiving weekly SMS text messages via mobile phone
plus standard of care to those receiving standard care. The standard of care at the TB
clinics for all LTBI patients includes provision of a 30 day supply of medications -
isoniazid 300mg daily for 9 months months or rifampin 600mg daily for 4 months - at a time,
monthly blood-work and monthly clinic visits. Successful treatment completion is defined as
taking at least 80% of the doses of INH prescribed within 12 months or at least 80% of the
doses of RIF prescribed within 6 months.
Secondary Objectives:
1. To compare the proportion of prescribed doses taken on schedule (daily adherence) prior
to medication discontinuation or interruption on medical advice between those receiving
weekly SMS text messages via mobile phone to those receiving standard care;
2. To measure patient satisfaction with the SMS intervention using a provider administered
questionnaire including a series of Likert questions.
4) Research Method
This study is a prospective open-label multicentre randomized controlled trial of a clinical
intervention. It is estimated that 350 study participants will be required to have 80% power
to detect a 15% difference in adherence at a .05 level of significance. In addition to
recruiting English-speaking participants, the investigators will also be recruiting
participants that have Chinese and Punjabi as their first language.
Upon consent, participants will be randomly assigned to receive either 1) standard of care
(9 months of INH or 4 months of RIF) and weekly SMS text messages via mobile phone or 2)
standard of care (9 months of INH or 4 months of RIF) without weekly SMS text messages via
mobile phone.
The clinicians, pharmacists and researchers involved in evaluating compliance will not be
blinded to the allocation of the intervention and control groups, as they will be required
to review patients charts periodically, respond to patients text messages when they are
experiencing difficulty in taking medications or side effects, as well as to ensure the
successful operation of the SMS technology platform.
;
Allocation: Randomized, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Health Services Research
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