Tuberc Respir Dis > Accepted Articles
DOI: https://doi.org/10.4046/trd.2022.0148    [Accepted]
Published online December 23, 2022.
Improving Tuberculosis Medication Adherence: The Potential of Integrating Digital Technology and Health Belief Model
Mohd Fazeli Sazali1, Syed Sharizman Syed Abdul Rahim1, Ahmad Hazim Mohammad1, Fairrul Kadir2, Alvin Oliver Payus3, Richard Avoi1, Mohammad Saffree Jeffree1, Azizan Omar1, Mohd Yusof Ibrahim1, Azman Atil1, Nooralisa Mohd Tuah4, Rahmat Dapari5, Meryl Grace Lansing3, Ahmad Asyraf Abdul Rahim1, Zahir Izuan Azhar6
1Department of Public Health Medicine, Faculty Medicine and Health Sciences, Universiti Malaysia Sabah, Malaysia
2Department of Emergency Medicine, Faculty Medicine and Health Sciences, Universiti Malaysia Sabah, Malaysia
3Department of Medicine, Faculty of Medicine and Health Science, Universiti Malaysia Sabah, Sabah, Malaysia
4Faculty of Computing and Informatics, Universiti Malaysia Sabah, Sabah, Malaysia
5Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
6Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia
Correspondence:  Syed Sharizman Syed Abdul Rahim, Tel: +6088-3200000, 
Email: syedsharizman@ums.edu.my
Received: 11 November 2022   • Revised: 3 December 2022   • Accepted: 16 December 2022
Abstract
Tuberculosis (TB) is a significant public health concern. Globally, TB is among the top ten and the leading cause of death due to a single infectious agent. Providing standard anti-TB therapy for at least six months is recommended as one of the crucial strategies to control the TB epidemic. However, the long duration of TB treatment raised the issue of non-adherence. Nonadherence to TB therapy could negatively affect clinical and public health outcomes. Thus, directly observed therapy (DOT) has been introduced as a standard strategy to improve anti-TB medication adherence. Nonetheless, the DOT approach has been criticized due to inconvenience, stigma, reduced economic productivity, and reduced quality of life, which ultimately could complicate adherence issues. Apart from that, its effectiveness in improving anti-TB adherence is debatable. Therefore, digital technology could be an essential tool to enhance the implementation of DOT. Incorporating the health belief model (HBM) into digital technology can further increase its effectiveness in changing behavior and improving medication adherence. This article aimed to review the latest evidence regarding TB medication non-adherence, its associated factors, DOT's efficacy and its alternatives, and the use of digital technology and HBM in improving medication adherence. This paper used the narrative review methodology to analyze related articles to answer the study objectives. Conventional DOT has several disadvantages in TB management. Integrating HBM in digital technology development is potentially effective in improving medication adherence. Digital technology provides an opportunity to improve medication adherence to overcome various issues related to DOT implementation.
Key Words: tuberculosis, adherence, directly observed therapy, digital technology, health belief model
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