Phoned pill reminders make inroads against TB

Coordinators of a tuberculosis-treatment project in Chiang Mai believe they have found a very promising new weapon in the long war against the disease, which the country has been losing for many years since the re-emergence of the illness.

Just a mobile phone with a cheap calling promotion has dramatically improved the success rate of the treatment.

Since a major factor blamed for the failure of TB treatment has been patients' inconsistency in taking the drugs, the project has come up with the idea of calling patients to remind them when it is time to take their medicine.

For three months, Chiang Mai, a province with a high number of TB patients, has been piloting the project on about 60 patients who are on a six-month TB treatment. The outcome has been very promising, said Dr Surasing Visrutarana, the province's chief health officer, adding that the drug-taking consistency rate was more than 90 per cent, compared to the average rate of successful treatment in the conventional programme.

Figures from the Public Health Ministry show new cases of TB stand at about 50 per 100,000 people, or about 90,000 cases a year, and the rate of successful treatment is still far below the World Health Organisation's standard of 85 per cent.

Each year at least 12,000 people die of TB. As a result, Thailand is grouped with the 22 "high-burden countries", alongside such impoverished countries as Mozambique, Zimbabwe, Uganda and Cambodia, which have much lower hygiene standards.

In the Chiang Mai mobile-phone project, the patients are given a phone with a calling promotion that allows them to receive calls only, and a number of trained volunteers who are former TB patients call to remind them on a daily basis when it is time to take the drug.

"To my amazement, the daily call is not just a good reminder to those patients who forget to take the drug, but it also comes in a way that makes them feel cared about and supported," said Surasing. "This leads to better cooperation on the part of the patients."

Using former patients as guardians is also an important part of the success because they have experience with TB drugs and treatment, he said.

"Advice and reassurance from an experienced person always sounds more convincing than from even a medical professional: they speak the same language," said Surasing.

Even before this pilot project is finished, Surasing hails it as a great success at a low price.

Actually, he said, this mobile project costs almost nothing. All that is required is a calling promotion worth about Bt100 per person, because most of the patients and volunteers have their own mobile phones.

This project will be concluded in the next three months, and then the success could spread, said Surasing.

Arthit Khwankhom

The Nation

Chiang Mai

The Nation Thailand
Sunday January 28, 2007