Barriers and facilitators of implementing electronic monitors to improve adherence and health outcomes in tuberculosis patients: Protocol for a systematic review based on the Consolidated Framework for Implementation Research

Abstract

Abstract Background Tuberculosis (TB) has been regarded as “a relentless scourge” which considerably increases morbidity and mortality as well as bringing heavy burdens on the vulnerable populations. A novel approach to TB called “electronic monitors” seems promising as an intervention, improving adherence and health outcomes and overcoming the weaknesses of the traditional interventions. However, no review has systematically examined and synthesized the influencing factors of implementing electronic monitors. Implementation research offers the means to analyze the influencing factors of the implementation and its process, fitting well with the aim of this review. Therefore, framework-based implementation research will be adopted to systematically identify barriers and facilitators of the electronic monitors that aim to improve adherence and health outcomes in TB patients. Methods and Analysis: The systematic review will follow the PRISMA guidelines. Literature research will be conducted in five electronic databases (MEDLINE, CINAHL, EMBASE, Cochrane Library, and Web of Science) to identify the barriers and facilitators of implementing electronic monitors in TB patients. The Consolidated Framework for Implementation Research (CFIR) will be used as a guide for categorizing and synthesizing the barriers and facilitators. Study screening, data extraction, quality appraisal, and data analysis will be conducted by two independent reviewers. The use of additional reviewers will solve any disagreements between the two reviewers. Discussion Given the increased prominence of TB epidemiology and the adherence problem of electronic monitors, there is a solid rationale for synthesizing the existing studies via an implementation science framework (CFIR). The findings and conclusion of this review will lay bare the achievements and effectiveness of implementing electronic monitors, as well as the attendant gaps and limitations. Further strategies for facilitating the implementation of electronic monitors will also be explored. Information provided by the review will be of essential significance for research and practice, supporting future academic research initiatives centered on TB patients and aiding the design of electronic monitors in lowering the morbidity and mortality associated with TB disease. Trial registration: PROSPERO: CRD42023395747.