Source:
MIT Spectrum (Helping TB patients. Spring 2008)

CellCentives Compliance Program

This article in Spectrum, a MIT in-house newsletter, celebrates the CellCentives progam, originally discussed in an AlignMap post, Yunus Challenge Award Focuses On Patient Compliance in May 2007.

To recap, CellCentives was one of the winners of the Yunus Challenge, the topic of which was “Increasing Adherence to Tuberculosis Drugs in Rural Developing Country Contexts”

Excerpts:

Commentary

I didn’t get it when I first wrote about this program almost a year ago, but now … well, I still don’t get it now.

Oh, I get the incentive part. What I don’t get is the implication that CellCentives is the equivalent of DOTS. A patient punching in a number from the packaging for a capsule is not the same as a nurse “actually go[ing] to the homes of TB patients to watch them take their medication.” Until there is research demonstrating that CellCentives is as effective as DOTS, the fact that CellCentives is cheaper is an empty boast. A plastic pill dispenser would be cheaper than CellCentives - but so what? Doing nothing is cheaper still.

Perhaps I’m missing something. But until someone can enlighten me, I feel compelled to suggest that despite visit[ing] five cities in India [to survey] tuberculosis patients and their doctors to learn why patients don’t take their medication,” perhaps these students didn’t get the entire story on compliance.

To repeat two of my shibboleths,

1. Being correctly educated to the need for medication and being reminded to take the medication are not the only factors with an impact on medication compliance
2. Removing a pill from its packaging is not as effective a treatment as actually taking the pill

Where’s my prize?

• Dispensing Pills In Style
• Organizing Data About Factors That Affect Compliance
• Connection Between Knowledge and Compliance Unclear
• Negative Effect Of Depression On Adherence To HIV Treatment Dissipates With SSRIs
• The Misdiagnosed Patient