ORCID Profile
0000-0002-8779-6421
Current Organisation
Universitas Padjadjaran
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Publisher: JMIR Publications Inc.
Date: 23-02-2022
DOI: 10.2196/33062
Abstract: Nonadherence to medication in tuberculosis (TB) h ers optimal treatment outcomes. Digital health technology (DHT) seems to be a promising approach to managing problems of nonadherence to medication and improving treatment outcomes. This paper systematically reviews the effect of DHT in improving medication adherence and treatment outcomes in patients with TB. A literature search in PubMed and Cochrane databases was conducted. Randomized controlled trials (RCTs) that analyzed the effect of DHT interventions on medication adherence outcomes (treatment completion, treatment adherence, missed doses, and noncompleted rate) and treatment outcomes (cure rate and smear conversion) were included. Adult patients with either active or latent TB infection were included. The Jadad score was used for evaluating the study quality. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline was followed to report study findings. In all, 16 RCTs were selected from 552 studies found, and 6 types of DHT interventions for TB were identified: 3 RCTs examined video directly observed therapy (VDOT), 1 examined video-observed therapy (VOT), 1 examined an ingestible sensor, 1 examined phone call reminders, 2 examined medication monitor boxes, and 8 examined SMS text message reminders. The outcomes used were treatment adherence, including treatment completion, treatment adherence, missed dose, and noncompleted rate, as well as clinical outcomes, including cure rate and smear conversion. In treatment completion, 4 RCTs (VDOT, VOT, ingestible sensor, SMS reminder) found significant effects, with odds ratios and relative risks (RRs) ranging from 1.10 to 7.69. Treatment adherence was increased in 1 study by SMS reminders (RR 1.05 95% CI 1.04-1.06), and missed dose was reduced in 1 study by a medication monitor box (mean ratio 0.58 95% CI 0.42-0.79). In contrast, 3 RCTs of VDOT and 3 RCTs of SMS reminders did not find significant effects for treatment completion. Moreover, no improvement was found in treatment adherence in 1 RCT of VDOT, missed dose in 1 RCT of SMS reminder, and noncompleted rate in 1 RCT of a monitor box, and 2 RCTs of SMS reminders. For clinical outcomes such as cure rate, 2 RCTs reported that phone calls (RR 1.30 95% CI 1.07-1.59) and SMS reminders (OR 2.47 95% CI 1.13-5.43) significantly affected cure rates. However, 3 RCTs found that SMS reminders did not have a significant impact on cure rate or smear conversion. It was found that DHT interventions can be a promising approach. However, the interventions exhibited variable effects regarding effect direction and the extent of improving TB medication adherence and clinical outcomes. Developing DHT interventions with personalized feedback is required to have a consistent and beneficial effect on medication adherence and outcomes among patients with TB.
Publisher: JMIR Publications Inc.
Date: 26-08-2021
Abstract: onadherence to medication in tuberculosis (TB) h ers optimal treatment outcomes. Digital health technology (DHT) seems to be a promising approach to managing problems of nonadherence to medication and improving treatment outcomes. his paper systematically reviews the effect of DHT in improving medication adherence and treatment outcomes in patients with TB. literature search in PubMed and Cochrane databases was conducted. Randomized controlled trials (RCTs) that analyzed the effect of DHT interventions on medication adherence outcomes (treatment completion, treatment adherence, missed doses, and noncompleted rate) and treatment outcomes (cure rate and smear conversion) were included. Adult patients with either active or latent TB infection were included. The Jadad score was used for evaluating the study quality. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline was followed to report study findings. n all, 16 RCTs were selected from 552 studies found, and 6 types of DHT interventions for TB were identified: 3 RCTs examined video directly observed therapy (VDOT), 1 examined video-observed therapy (VOT), 1 examined an ingestible sensor, 1 examined phone call reminders, 2 examined medication monitor boxes, and 8 examined SMS text message reminders. The outcomes used were treatment adherence, including treatment completion, treatment adherence, missed dose, and noncompleted rate, as well as clinical outcomes, including cure rate and smear conversion. In treatment completion, 4 RCTs (VDOT, VOT, ingestible sensor, SMS reminder) found significant effects, with odds ratios and relative risks (RRs) ranging from 1.10 to 7.69. Treatment adherence was increased in 1 study by SMS reminders (RR 1.05 95% CI 1.04-1.06), and missed dose was reduced in 1 study by a medication monitor box (mean ratio 0.58 95% CI 0.42-0.79). In contrast, 3 RCTs of VDOT and 3 RCTs of SMS reminders did not find significant effects for treatment completion. Moreover, no improvement was found in treatment adherence in 1 RCT of VDOT, missed dose in 1 RCT of SMS reminder, and noncompleted rate in 1 RCT of a monitor box, and 2 RCTs of SMS reminders. For clinical outcomes such as cure rate, 2 RCTs reported that phone calls (RR 1.30 95% CI 1.07-1.59) and SMS reminders (OR 2.47 95% CI 1.13-5.43) significantly affected cure rates. However, 3 RCTs found that SMS reminders did not have a significant impact on cure rate or smear conversion. t was found that DHT interventions can be a promising approach. However, the interventions exhibited variable effects regarding effect direction and the extent of improving TB medication adherence and clinical outcomes. Developing DHT interventions with personalized feedback is required to have a consistent and beneficial effect on medication adherence and outcomes among patients with TB.
Publisher: Hindawi Limited
Date: 11-2022
DOI: 10.1155/2022/5729217
Abstract: Stenochlaena palustris (Burm.f.) Bedd. (Blechnaceae) or Kelakai is a traditional medicinal plant found in the Indonesian islands of Borneo and Sumatra. It has been used to treat wound healing, infection, and diabetes. This study looked into the free radical scavenging activity, antiplasmodial activity, toxicity, and antibacterial activity against pathogenic bacteria. The species’ aerial part was extracted with methanol, followed by a liquid-liquid extraction against (n-hexane, dichloromethane, and ethyl acetate). The extracts’ free radical scavenging activities were determined using DPPH and NO radicals. The antiplasmodial and toxicity assays were conducted using two Plasmodium falciparum strains (3D7 and W2) and the brine shrimp lethality test. In addition, antibacterial activity was determined using the well diffusion method. The results revealed that ethyl acetate depicted potential activities toward the assay. The ethyl acetate showed potential free radical scavenging activities with an IC50 value of 51.63 ± 0.46 μg/mL (DPPH) and 60.03 ± 0.65 μg/mL (NO). The antiplasmodial activities showed that the ethyl acetate had potential activities among the extracts with an IC50 value of 11.06 ± 0.45 μg/mL. However, all the extracts demonstrated nontoxic toward Artemia salina with LC50 1000 μg/mL. Furthermore, the ethyl acetate demonstrated intermediate susceptibility against B. cereus ATCC 10876, V. parahaemolyticus ATCC 17802, L. monocytogenes ATCC 7644, and S. Typhimurium ATCC 14028 at a concentration of 500 μg/disc. According to these findings, the ethyl acetate extract of S. palustris (Burm.f.) Bedd is a promising source of natural antioxidants and antiplasmodial agents.
No related grants have been discovered for Rizky Abdulah.