Grant: Partnerships for Health System Improvement (PHSI)

Treatment for latent tuberculosis infection (LTBI) is important for the control of disease progression and prevention of disease transmission. However, a large proportion of people who are prescribed pills for LTBI do not finish treatment. Advances in cellular phone communications and the increase in the use of text messaging present new opportunities for health systems to conveniently reach increasing numbers of people and strengthen client-centered care. We have developed a support program for patients with LTBI to encourage them to take the required amount of medications. This program, called WelTel-LTBI, consists of a weekly text message asking "How are you?" Participants will be asked to reply indicating that they do not have any problems (e.g."OK."), or alternatively, that they have an issue to discuss (e.g. "Not well."). Participants who have indicated there is a problem will be referred to the Tuberculosis (TB) Clinic nurses for follow-up and will be triaged as needed. In a previous clinical trial, we demonstrated that weekly text messages sent to HIV positive patients on antiretroviral treatment helped increase medication adherence and decreased their viral load counts. The objective of this study is to determine what impact this program has on the health of LTBI patients and on the Canadian health care system, including the cost-effectiveness of WelTel-LTBI compared with standard care for LTBI. This study will focus on the initial roll-out of WelTel-LTBI, which will include two provincial TB Control Clinics. The results of this study will be used to expand this program throughout British Columbia. This research is an important step forwards in advancing the science of using wireless communications technology in health care to improve health outcomes in LTBI patients both in Canada and abroad.