@article {Gashue100268, author = {Kassahun Dessie Gashu and Kassahun Alemu Gelaye and Richard Lester and Binyam Tilahun}, title = {Effect of a phone reminder system on patient-centered tuberculosis treatment adherence among adults in Northwest Ethiopia: a randomised controlled trial}, volume = {28}, number = {1}, elocation-id = {e100268}, year = {2021}, doi = {10.1136/bmjhci-2020-100268}, publisher = {BMJ Specialist Journals}, abstract = {Objectives This study aimed to evaluate the effect of the phone reminder system on patient-centred TB treatment adherence during continuation phase, where patients are responsible for taking medication at home.Methods We conducted a two-arm randomised controlled trial on adult patients with TB during the continuation phase. In the intervention arm, patients received routine care plus phone-based weekly pill refilling and daily medication reminders. In the control arm, participants received only routine care. A covariate adaptive randomisation technique was used to balance covariates during allocation. The primary outcome was adherence to patient-centred TB treatment, and secondary outcomes included provider{\textendash}patient relationship and treatment outcomes. We applied per-protocol and intention-to-treat analysis techniques.Results We randomised 306 patients to intervention (n=152) and control (n=154) groups. Adherence to patient-centred TB treatment was 79\% (110/139) in intervention and 66.4\% (95/143) in control groups, with relative risk (RR) (95\% lower CI) (RR=1.632 (1.162 to $\infty$); p=0.018, one tailed). Good provider{\textendash}patient relationship was 73.3\% (102/139) in intervention group and 52.4\% (75/143) in control group, p=0.0001. TB treatment success was 89.5\% (136/152) in intervention group and 85.1\% (131/154) in control group, p=0.1238.Conclusions Mobile phone-based weekly refilling with daily medication reminder system improved adherence to patient-centred TB treatment and provider{\textendash}patient relationship; however, there was no significant effect on treatment success.Trial registration number Pan African Clinical Trials Registry (PACTR201901552202539).All data relevant to the study are included in the article. The protocol is published and available in the same journal (BMJ Health \& Care Informatics).}, URL = {https://informatics.bmj.com/content/28/1/e100268}, eprint = {https://informatics.bmj.com/content/28/1/e100268.full.pdf}, journal = {BMJ Health \& Care Informatics} }