A novel approach to monitoring adherence to preventive therapy for tuberculosis in adolescence.
OBJECTIVE
To evaluate the usefulness of a microelectronic tablet-dispenser for monitoring adherence to preventive therapy for tuberculosis infection in adolescents.


METHODS
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.
Starr
M
M
Department of Microbiology and Infectious Diseases, Royal Children's Hospital, Parkville, Victoria, Australia. starrm@cryptic.rch.unimelb.edu.au
Sawyer
S
S
Carlin
J
J
Powell
C
C
Newman
R
R
Johnson
P
P
D000293:Adolescent; D000995:Antitubercular Agents / Q000008:administration & dosage*; D016903:Drug Monitoring / Q000379:methods*; D004360:Drug Therapy, Computer-Assisted; D006801:Humans; D007538:Isoniazid / Q000008:administration & dosage*; D010349:Patient Compliance; D010865:Pilot Projects; D014376:Tuberculosis / Q000517:prevention & control*
D000995:Antitubercular Agents; D007538:Isoniazid