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Tech Takes on Tuberculosis: Smartphones and Medication Adherence

Tech Takes on Tuberculosis: Smartphones and Medication Adherence

Often thought of as the disease that took out 19th-century opera heroines, in our modern day, pulmonary tuberculosis is far from obsolete. It killed 1.7 million people worldwide in 2016 alone. While antibiotics to fight TB were developed in the 1940s, many strains of the bacterium are drug-resistant, and can result in a painful, bloody, suffocating illness, in addition to possible death. Tuberculosis is also pretty contagious, spread when a sufferer coughs up the bacterium, which is then inhaled by someone else.
 
It’s therefore SUPER IMPORTANT that people with TB take the correct (and functional!) medications at their proper times. The traditional method of making sure this happens is to have a health professional visit a patient daily, bearing a barrage of meds, and have the patient take them while being observed. But that gets tricky in diffuse populations, or when clinic resources are tight. Enter, technology — specifically that tiny computer in everyone’s pocket, the smartphone!
 
Now I’ve set alarms on my own phone to remind me to take antibiotics, but the new app created by a team out of Johns Hopkins and UC San Diego takes patient accountability one step further. Called SureAdhere the app allows a patient to take their meds in front of their smartphone camera, then send the encrypted video to a medical professional, who reviews the images and ensures everything is as it should be.
 
This innovation grew out of difficulties experienced with medication adherence in San Diego County, an area of California next to the Mexican border.
 
“In 2010, [SureAdhere founder and UCSD professor Richard] Garfein’s group began a two-year study of video-monitored observation of 52 patients in San Diego and Tijuana that ultimately confirmed its efficacy: 93 percent and 96 percent of patients in those cities, respectively, adhered to their drug regimens while using video monitoring over an average of 5.5 months. Those rates are comparable to those of patients monitored through in-person therapy. A separate study in New York City reported an adherence rate of 95percent for patients using video monitoring, compared with 91 percent for patients who received in-person visits.”

This app not only frees up clinicians, who don’t have to spend time and money driving to their patients anymore, but the patients as well: the videos can be taken and uploaded securely anytime, and the patient isn’t tied down waiting for a home visit!
 
Some hurdles involve the prohibitive cost of smartphones for some people, as well as difficulties in understanding their operation. But, while capitalism and education work to lower those hurdles, this app can begin saving lives — and restoring livelihoods — to sufferers of tenacious TB.