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Reminder systems and late patient tracers in the diagnosis and management of tuberculosis

Liu, Q., Abba, Katharine, Alejandria, M. M., Balanag, V. M., Berba, R. P. and Lansang, M. A. D. (2008) 'Reminder systems and late patient tracers in the diagnosis and management of tuberculosis'. Cochrane Database of Systematic Reviews, Issue 4-CD006594.

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Reminder systems and late patient tracers as strategies to improve patients' adherence to tuberculosis screening, diagnosis, and treatment are used in some countries, but their effectiveness has not previously been systematically reviewed.
To assess the effects of reminder systems and late patient tracers on completion of diagnostics, commencement of treatment in people referred for curative or prophylactic treatment of tuberculosis, completion of treatment in people starting curative or prophylactic treatment for tuberculosis, and cure in people being treated for active tuberculosis.
Search strategy
We searched the Cochrane Infectious Diseases Group Specialized Register ( June 2008), Cochrane Effective Practice and Organization of Care Group Specialized Register ( April 2007), CENTRAL ( The Cochrane Library 2008, Issue 2), MEDLINE ( 1966 to June 2008), EMBASE ( 1974 to June 2008), LILACS ( 1982 to June 2008), CINAHL ( 1982 to June 2008), SCI-EXPANDED ( 1945 to June 2008), SSCI ( 1956 to June 2008), mRCT ( June 2008), Indian Journal of Tuberculosis ( 1983 to June 2008), and reference lists. We also contacted researchers working in the field.
Selection criteria
Randomized controlled trials (RCTs), including cluster RCTs and quasi-RCTs, and controlled before-and-after studies comparing any reminders or late patient tracers with no or other kinds of reminders or late patient tracers. We included people in any setting who require treatment for tuberculosis or require prophylaxis against tuberculosis and are referred to tuberculosis diagnostic or screening services.
Data collection and analysis
Two authors independently assessed trial risk of bias and extracted data. Nometa-analysis could be undertaken due to the heterogeneity of interventions across trials.
Main results
Nine trials involving 5257 participants met the inclusion criteria. Three assessed the use of late patient tracers, and six assessed reminder systems. Late patient tracers ( home visit and letter) were shown to be beneficial in increasing adherence to tuberculosis treatment compared with no late patient tracer. The results from almost all the reminder trials, except one, show benefits of different types of reminders compared to no reminder on adherence to tuberculosis clinic appointments.
Authors' conclusions
The included trials show significantly better outcomes among those tuberculosis patients for which late patient tracers and reminders are used. Studies of good quality ( large and with rigorous study design) are needed to decide the most effective late patient tracer actions and reminders in different settings. Future studies of reminders in chemoprophylaxis and treatment settings would be useful.

Item Type: Article
Additional Information: This review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews 2008, Issue 4. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review. Citation: Liu Q, Abba K, Alejandria MM, Balanag VM, Berba RP, Lansang MAD. Reminder systems and late patient tracers in the diagnosis and management of tuberculosis. Cochrane Database of Systematic Reviews 2008, Issue 4. Art. No.: CD006594. DOI: 10.1002/14651858.CD006594.pub2
Uncontrolled Keywords: directly observed therapy pulmonary tuberculosis improve adherence health-education controlled-trial drug-resistance antituberculosis chemoprophylaxis chemotherapy adolescents
Subjects: WF Respiratory System > Tuberculosis > WF 200 Tuberculosis (General)
WF Respiratory System > Tuberculosis > WF 220 Diagnosis. Prognosis
WF Respiratory System > Tuberculosis > WF 310 Therapy
Faculty: Department: Groups (2002 - 2012) > International Health Group
Digital Object Identifer (DOI):
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Depositing User: Philomena Hinds
Date Deposited: 16 Jul 2010 11:31
Last Modified: 17 Aug 2022 08:56


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