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Int. J. Environ. Res. Public Health 2017, 14(10), 1115;

Usability of a Medication Event Reminder Monitor System (MERM) by Providers and Patients to Improve Adherence in the Management of Tuberculosis

National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Department of Medicine, Stanford University, Stanford, CA 94305, USA
The Arcady Group, Richmond, VA 23226, USA
Institute of Nursing Science, University of Basel, CH-4056 Basel, Switzerland
PATH China Program, Beijing 100600, China
Bill and Melinda Gates Foundation, Beijing 100027, China
Author to whom correspondence should be addressed.
Received: 31 July 2017 / Revised: 11 September 2017 / Accepted: 16 September 2017 / Published: 25 September 2017
(This article belongs to the Section Global Health)
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Poor initiation and implementation and premature discontinuation of anti-tuberculous therapy, all forms of nonadherence, are major reasons for treatment failure, the development of drug-resistant tuberculosis, and transmission to other non-infected individuals. Directly Observed Therapy (DOT) has been the worldwide standard, but implementation of DOT is burdensome for providers and patients, especially in resource-limited settings, where most of the burden of active TB is located. Among the alternatives to DOT is electronic monitoring (EM) of drug dosing histories. Here we report a usability study of a newly-designed, modular electronic monitor product, called the MERM (Medication Event and Reminder Monitor), that is compatible with TB medication formats and supply chains in resource-limited settings. This study, done in a rural setting in China, showed that the use of the MERM for EM of TB medications was associated with a high degree of user performance, acceptability, and satisfaction among both TB patients and medical staff. Based on these data, EM is becoming the standard of care for drug-susceptible TB patients in China and scaled implementations in several other countries with high TB burden have begun. In addition, the MERM is being used in MDR-TB patients and in clinical trials involving patients with TB/HIV and latent TB. View Full-Text
Keywords: adherence; tuberculosis; management; monitoring technology; usability adherence; tuberculosis; management; monitoring technology; usability

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Liu, X.; Blaschke, T.; Thomas, B.; De Geest, S.; Jiang, S.; Gao, Y.; Li, X.; Buono, E.W.; Buchanan, S.; Zhang, Z.; Huan, S. Usability of a Medication Event Reminder Monitor System (MERM) by Providers and Patients to Improve Adherence in the Management of Tuberculosis. Int. J. Environ. Res. Public Health 2017, 14, 1115.

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