A novel approach to monitoring adherence to preventive therapy for tuberculosis in adolescence

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Abstract
Objectives: To evaluate the usefulness of a microelectronic tablet‐dispenser for monitoring adherence to preventive therapy for tuberculosis infection in adolescents. Methodology: Twenty‐one patients with positive Mantoux tests were treated with isoniazid (INH), dispensed in a microelectronic tablet‐dispenser that recorded the date, time and duration that the container was opened. Other measures of adherence included attendance at clinic, patient self‐report, tablet count, and measurement of urinary INH metabolites. Results: The mean adherence rates were: 83% using attendance at clinic, 91% using tablet counts, 79% using urine assays, and 66% using the electronic tablet‐dispenser. Self‐reporting appeared to over‐estimate adherence. Conclusions: Adherence to 6 months of INH calculated using different measures is higher in this study than in previous reports. Microelectronic tablet‐dispensers are an effective method to objectively measure adherence on a daily basis. Other measures are less helpful.