1. Authors: Archana Trivedi1, Sarabjit Chadha1, Suneetha Nareddy2, Asra Farheen, J Suresh 3, Karuna Sagili1 1International Union Against Tuberculosis and Lung Disease, The Union South East Asia Office 2 Apollo Hospitals Jubilee Hills Hyderabad, India 3 Kevin Corporation Bangalore, India
# Unite to End TB: Collaboration with Corporate Hospital, E-Tool Based Solution for Better Outcome of TB Patients Treated in Private Sector– Experience from India
In India, TB incidence is 2.8 million annually.
One million are missed, either not notified/diagnosed.
Under World TB Day campaign “Unite to End TB”; partnering with private health care providers will be vital in our endeavour to End TB in India where 50% TB patients treated in private sector (Satyanarayana etal 2011) which is diverse - unqualified to corporate hospitals.
Lack of standardised protocols/treatment adherence mechanism results in incomplete and irregular treatment and thus promotes DR-TB.
TB was declared notifiable disease in India (2012); however notification by private providers is sub-optimal/poor (Yeole etal 2015).
Strategy developed to engage corporate hospitals by updating physicians on TB /DR-TB, notification and ensuring adherence for favourable outcome.
Innovative e-tool - web based software developed which registers, track and monitor TB patients.
Reminders sent to patients for medication, follow up visits/tests which are in form of daily mobile SMS & twice weekly IVRC (Integrated Voice Recording Calls).
Piloted at one of the largest corporate hospitals in India (Apollo Hospital Hyderabad)
During June Mar 2017, 500 TB patients were notified from the hospital to National TB Program (NTP)
Male: Female ratio 1.41, children 6 % (n=30). Majority is extra-pulmonary 74%. (n=373), probably being tertiary care centre as well as availability of diagnostic tests.
Comorbidities were TB-DM 5% (n=25) and TB-HIV 3.4% (n=17). 71% (n=355) consented for reminders.
Comparative analysis of outcome of patients given consent for IVRS with the ones not given consent shows 74% (n=141) had successful outcome compared to 43% (n=28) who had not given consent (p = 0.00).
Retention of patients was more 95% with the patients who had given consent compared to 57% who had not given consent (p=0.00).
Cost was less than 2$/patient for treatment of TB patient for 6 months.
User friendly & cost effective innovative model for notification and promoting treatment adherence provides better outcome of TB patients being treated in private sector.
This e-tool helps in evaluation of outcome and compliance of treatment.
Bypasses all blocks for notification, avoids notification and treatment initiation without confirming diagnosis.
Scope of onsite/offsite operational research.
Introduction
Methods
Results
Conclusions