ELECTRONIC MONITORING OF ADHERENCE TO TREATMENT IN THE PREVENTIVE CHEMOTHERAPY OF TUBERCULOSIS

SETTING: Non-adherence to treatment is a frequent problem in the preve ntive chemoprophylaxis of tuberculosis. OBJECTIVE: To evaluate the use fulness of the Medication Event Monitoring System (MEMS(R)) for follow ing and improving patient adherence to 6-month treatment with isoniazi d. DESIGN: Three methods of monitoring compliance, MEMS, pill count an d a urine test for isoniazid, were compared prospectively in 30 patien ts. The efficacy of a combined intervention by the physician and the p harmacist was evaluated in non-compliant patients. RESULTS: According to the MEMS data, overall adherence to isoniazid therapy was 91.5%, an d 86% of the patients were considered compliant throughout the period of observation. The pill count and the urine test tended to overestima te the overall compliance when compared to the MEMS. The combined inte rvention of the physician and pharmacist allowed drug adherence to be enhanced in non-compliant patients, but the effect was only transient if this was not repeated every month. CONCLUSION: Our results suggest that the MEMS system is a useful approach for monitoring and improving compliance with preventive chemotherapy for tuberculosis.