BACKGROUND
Poor adherence to anti-tuberculosis treatment is a main threat for the treatment success. Digital health interventions such as electronic monitors (e-monitors) and the WeChat application (app) may improve treatment adherence in TB patients.
OBJECTIVE
The study aimed to examine the key facilitators, barriers, and drivers of barriers of implementing e-monitors and the WeChat app.
METHODS
Personal, semi-structured interviews with workers in healthcare institutions in three cities in Inner Mongolia were conducted between June and December 2023 when e-monitors and the WeChat app were introduced as part of a TB treatment strategy. The consolidated framework for implementation research (CFIR) was used to develop interview questions.
RESULTS
A total of 143 healthcare workers were interviewed. The key facilitators included the e-monitors helped to improve medication adherence. Second, the intervention itself was cost-effective. Respondents took the initiative to learn about the intervention. Finally, the indicators were implemented through a top-down process, which increased the efficiency of the implementation of this policy decision. The key barriers were insufficient external financial incentives, available resources are inadequate in primary healthcare setting, negative attitudes of the implementers, a lack of feedback in implementation. Drivers of barriers included the values with limited utility of the intervention, rigid organizational administrative hierarchy, and rights and responsibilities mismatch.
CONCLUSIONS
policymakers should pay attention to the barriers and its drivers to implementing the intervention. Adherence to patient-cantered, cultivate a teamwork atmosphere, and improve incentives and performance evaluation systems are necessary to improve the implementation of the intervention.
CLINICALTRIAL
ISRCTN15169616. Registered on 29 July 29, 2023