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Table 1 Differentiated care response to patient adherence in intervention arms

From: Evaluation of implementation and effectiveness of digital adherence technology with differentiated care to support tuberculosis treatment adherence and improve treatment outcomes in Ethiopia: a study protocol for a cluster randomised trial

Trigger Intervention
Dose recorded (daily) Medication label: message confirmation from patient of recorded dose
Smart pill box: box opening (sound and/or light)
Patient missed daily dose (1 day) Same day: patient receives a reminder SMS at 3 pm*
Next day: HCW will receive a notification of patients with a missed dose on their Task List
Follow-up actions: phone call to patient or treatment supporter, unless HCW is aware of a network issue**
Missed daily dose (2 consecutive days) Same day: patient receives a reminder SMS at 3 pm*
Next day: HCW will receive a notification of patients with a missed dose ion their Task List
Follow-up actions: phone call to patient or treatment supporter**, unless HCW is aware of a network issue***
Patient persistently missed doses (≥ 5 consecutive doses or multiple times)*** Escalation to community health worker for home visit using a standardised set of messages and counselling
Patient persistently missed doses (> 14 consecutive doses or multiple times missing 7 doses) Discontinuation from DAT intervention and switch to daily DOT under the HCWs observation for TB patients with persistent non-adherence will be considered
  1. SMS short message service; HCW health care worker
  2. *Among patients with a mobile phone; **If daily DOT resumes as the standard of care, phone calls will be replaced with escalation to community health worker for home visit; *** among patients with mobile phone access (either their own or treatment supporter)