TB-TST mobile application increases treatment success to 82% in drug susceptible tuberculosisMobile App Improves Success Rates for Tuberculosis Treatment

BMJ (Clinical research ed.) Published August 9, 2026 Study authors: Rubinstein Fernando, Moraes Morelli Daniela, Palma Ileana, Sanjurjo Myrian, Morales Rosana, Bornengo… PubMed ↗ NCT04221789 ↗ DOI ↗ Editorial oversight: Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

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Key Takeaway

Consider TB-TST as a feasible tool to improve treatment success and retention in drug susceptible tuberculosis patients.

This pragmatic randomized controlled trial enrolled 555 individuals aged $≥$16 years with newly diagnosed drug susceptible tuberculosis in Argentina. Participants were assigned to either standard of care (n=278) or standard of care plus TB-TST (n=277). The TB-TST intervention included a mobile application featuring daily adherence reporting, bidirectional messaging with treatment supporters, educational content, and weekly urine based isoniazid tests.

Treatment success, defined as cure or treatment completion, was higher in the intervention group at 82% compared to 74% in the control group (risk ratio 1.10; risk difference 7.1%; 95% confidence interval 1.1% to 14.1%; P=0.04). Additionally, loss to follow-up was lower in the intervention group at 17% compared to 24% in the control group (risk ratio 0.70; 95% confidence interval 0.50 to 0.98; P=0.04).

Safety data and specific adverse events were not reported, though 30 individuals were excluded for protocol deviations. Limitations include that the impact of app engagement was not evaluated, cost effectiveness was not assessed, and context factors like the COVID-19 pandemic were not fully analyzed. The tool demonstrated feasibility in supporting adherence, particularly among women and patients under 35 years.

How this fits prior evidence

How this fits prior evidence: This finding addresses a gap in nonpharmacological interventions for drug susceptible tuberculosis by demonstrating that mobile health tools can improve treatment success rates. While previous coverage noted that modified regimens show higher success rates than standard regimens for drug-resistant tuberculosis in Cameroon, this study focuses on improving outcomes in drug susceptible cases through digital support and monitoring.

Researchers conducted a trial in Argentina involving 555 people newly diagnosed with drug-susceptible tuberculosis. The study compared standard care against a program called TB-TST. This intervention included a mobile app for daily reporting, messaging with support staff, educational content, and weekly urine tests to check if patients were taking their isoniazid medication.

The results showed that the group using the mobile app had a higher success rate of 82 percent compared to 74 percent in the standard care group. Additionally, fewer people in the app group dropped out of treatment. The study noted that this tool was particularly helpful for women and patients under the age of 35.

While the results are promising, there are some limitations to keep in mind. The study did not measure how much time people spent on the app or its cost-effectiveness. Because it took place during the COVID-19 pandemic, some outside factors might have influenced the results. This tool is currently only tested for tuberculosis and has not been evaluated for other conditions.

What this means for you:

A mobile app with support messaging helped more patients successfully complete their tuberculosis treatment.

Common questions

How did the mobile app help patients with tuberculosis?

The app, called TB-TST, provided several tools to help patients stay on track. It included a way to report daily progress, educational content, and two-way messaging with treatment supporters. It also included a weekly urine test to check if the patient was taking their isoniazid medication correctly.

Was the app more effective for certain groups?

The study found that the tool was particularly useful in supporting treatment adherence among women and patients under the age of 35. These groups showed benefit from the combination of digital tools and support.

What were the specific success rates for the two groups?

Patients using the mobile app had a success rate of 82 percent, while those receiving standard care had a success rate of 74 percent. The study also found that fewer people in the app group were lost to follow-up compared to the standard care group.

Study Details

Study typeRct

Sample sizen = 278

EvidenceLevel 2

Follow-up192.0 mo

PublishedAug 2026

PMID42562413

TrialNCT04221789

View Original Abstract ↓

OBJECTIVE: To evaluate the effectiveness of Tuberculosis Treatment Support Tools (TB-TST), a patient centred digital adherence technology, in improving treatment outcomes among individuals with drug susceptible tuberculosis in Argentina. DESIGN: Pragmatic, two arm, parallel randomised controlled trial. SETTING: Four public reference hospitals in Buenos Aires, Argentina. PARTICIPANTS: 555 patients aged ≥16 years with newly diagnosed drug susceptible tuberculosis, recruited between November 2020 and July 2023, randomised to standard of care (n=278) or standard of care plus TB-TST (n=277). INTERVENTION: A mobile application that enabled daily adherence reporting, bidirectional messaging with treatment supporters, educational content, and a weekly urine based isoniazid test for verification of adherence. Participants and care givers were aware of their group assignment, but data collectors and data analysts were masked. MAIN OUTCOME MEASURES: The primary outcome was treatment success (cure or treatment completion). Secondary outcomes included loss to follow-up. Analyses used intention-to-treat and per protocol approaches. RESULTS: 525 participants (94.6% of the enrolled population) were included in the analysis after exclusion of 30 individuals who deviated from the protocol. In the intention-to-treat analysis, treatment success was higher in the intervention group (208/255; 82%) than in the control group (201/270; 74%). The risk difference was 7.1% (95% confidence interval 1.1% to 14.1%), and the risk ratio was 1.10 (1.00 to 1.20; P=0.04). Loss to follow-up was lower in the intervention group (17% 24%; risk ratio 0.70, 0.50 to 0.98; P=0.04). Greater benefit was observed among female participants and those aged under 35 years. CONCLUSIONS: A multifaceted, interactive digital adherence tool improved tuberculosis treatment outcomes, particularly among younger participants and women, showing feasibility and effectiveness in supporting adherence to tuberculosis treatment in low resource settings. Future research should evaluate the impact of app engagement, context factors such as the covid-19 pandemic, cost effectiveness, and use of the tool beyond tuberculosis in the management of chronic diseases. AI powered features and integrated mental health support may enhance the scalability and personalisation of care. TRIAL REGISTRATION: ClinicalTrials.gov NCT04221789; International Registered Report Identifier DERR1-10.2196/28094.

TB-TST mobile application increases treatment success to 82% in drug susceptible tuberculosisMobile App Improves Success Rates for Tuberculosis Treatment

How this fits prior evidence

Common questions

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TB-TST mobile application increases treatment success to 82% in drug susceptible tuberculosisMobile App Improves Success Rates for Tuberculosis Treatment

How this fits prior evidence

Common questions

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