Project: "Digital Health Adherence in Ukraine"
To explore practical aspects of using Digital Adherence Technologies (DATs) in local context in Ukraine, the W6 TB REACH project, implemented by PATH-Ukraine, with LHSI acting as a Sub-contractor, piloted the use of EvriMED1000 SMART boxes in out-patient models of TB treatment, including chemo-resistant TB and MDR-TB, from November 2018 to December 2019 in high TB burden oblasts in southern Ukraine.
99DOTS online platform was used to monitor the signal from Smartbox signalizing the medication uptake by the patient. The use of DATs followed Unified Clinical Protocol of primary, secondary and tertiary health care for Tuberculosis patients and Standard Operational Procedures (SOPs) to monitor treatment of TB patients at the regional level. The project used evriMED pillboxes - medication reminder and digital remote treatment adherence monitoring devices, also called ‘SMART-boxes’.
The use of Sureadhere VDOT was also considered, but was not evaluated since its implementation was delayed. There is a potential of using Sureadhere and other apps in Ukraine. Project providers reported a high use of their smart phones when monitoring patients and some responses suggested video monitoring at drug intake from the boxes.
TB-REACH W6 project was implemented by PATH in two high TB burden southern oblasts (provinces) of Ukraine - Odesa and Mykolayiv
Project implemented active case finding and supported TB screening, diagnosis, counselling and treatment supervision within communities using a suite of technologies: evriMED pillboxes.
Results: From a total of 1712 registered patients, 902 (53%) patients diagnosed by regional TB facilities were initiated TB treatment under 99DOTS project in 21 different TB sites in Odesa and Mykolayiv oblasts. [Mean age of the registered TB patients was years with predominance of “new cases” (n = 647 , 71%) and “male” gender (n = 585, 63,9%).]