Titulo Estágio
AdherenceTech - Digital Adherence Technologies: Social and affective aspects
Local do Estágio
Porto or Remote Work
Enquadramento
Motivation and background:
Treatment non-adherence, a pervasive issue in healthcare since antiquity (Wright et al., 2023), poses a significant challenge to managing or curing various health conditions effectively. Inherently curable diseases, such as Tuberculosis (TB), can lead to unfavourable health outcomes due to non-adherence to the months-long drug regime (Kumari, 2023). The World Health Organization reports that TB, despite being curable, remained the world’s second leading cause of death from a single infectious agent in 2022, after COVID-19, and caused almost twice as many deaths as HIV/AIDS, making it one of the world’s top infectious killer and a major contributor to antimicrobial resistance.
For decades, the standard international strategy to address TB treatment non-adherence, as recommended by WHO, has been Directly Observed Treatment (DOT). This involves having medical personnel, community volunteers, or family members observe the patient taking each medication dosage in person. Many technology-centric approaches are emerging as alternatives, such as Electronic Directly Observed Treatment (eDOT) or Video Directly Observed Treatment (VDOT), where medical personnel can observe a video of the patient synchronously or asynchronously taking their medicine. There are also emerging solutions that use artificial intelligence to automate DOT.
Relevance:
Many patients with chronic illnesses or in need of long-term therapy struggle to adhere to recommended therapy, including those with asthma, hypertension, diabetes, and HIV/AIDS. Although eDOT is generally considered more patient-centric due to its flexibility in allowing patients to take their medication at their desired time and place (Kumari, 2023), current technological solutions still have room to incorporate other critical human factors that can impact treatment adherence. Adherence is a multidimensional phenomenon that requires a combination of different strategies and dynamic and complex changes of many players over extended periods to be effective (WHO, 2003). Informal and formal social support has been consistently reported as an important factor affecting health outcomes and behaviours (WHO, 2003), with patients valuing the encouragement and reassurance provided by their healthcare providers (Rabinovich et al., 2020).
Objetivo
Objective:
Address the opportunity of eDOT solutions to tackle patients’ needs beyond mere medication tracking, focusing on more nuanced affective and social dimensions of treatment adherence.
Plano de Trabalhos - Semestre 1
Workplan:
1. Literature Review;
2. User Research.
Plano de Trabalhos - Semestre 2
Workplan:
3. Co-design sessions;
4. Prototyping and Testing;
5. Thesis Writing.
Condições
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Observações
References:
- Wright, D. F. B., Sinnappah, K. A., & Hughes, D. A. (2023). Medication adherence research comes of age. British Journal of Clinical Pharmacology, 89(7), 1914–1917. https://doi.org/10.1111/bcp.15722
- World Health Organization. (2003). Adherence to long-term therapies : evidence for action. World Health Organization. https://iris.who.int/handle/10665/42682
- World Health Organization. Communicable Diseases Cluster. (1999). What is DOTS? : a guide to understanding the WHO-recommended TB control strategy known as DOTS. World Health Organization. https://iris.who.int/handle/10665/65979
- World Health Organization. (2023). Global tuberculosis report 2023. World Health Organization. https://iris.who.int/handle/10665/373828. License: CC BY-NC-SA 3.0 IGO
- Kumari, U., Wasim, U., Kumari, S., & Khoshbakht, F. (2023). Electronic directly observed therapy (eDOT) therapy: A digital breakthrough in tuberculosis treatment – A commentary. Annals of Medicine and Surgery, 85(5), 2268–2269. https://doi.org/10.1097/MS9.0000000000000668
- Rabinovich, L., Molton, J. S., Ooi, W. T., Paton, N. I., Batra, S., & Yoong, J. (2020). Perceptions and Acceptability of Digital Interventions Among Tuberculosis Patients in Cambodia: Qualitative Study of Video-Based Directly Observed Therapy. Journal of Medical Internet Research, 22(7), e16856. https://doi.org/10.2196/16856
Orientador
Isabella Barbosa Silva
isabella.silva@aicos.fraunhofer.pt 📩