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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)