Mobile health applications called Digital Adherence Technologies (DATs) are increasingly used for improving treatment adherence among Tuberculosis patients to attain cure, and/or other chronic diseases requiring long term and complex medication regimens. These DATs are found to be useful in resource limited settings because of their cost efficiency in reaching out to vulnerable groups (providing pill & clinic visit reminders, health information and awareness on the disease along with motivational messages and support to be retained in care) or those staying in remote or rural areas. Despite their growing ubiquity, there is very limited evidence on how they improve healthcare outcomes. We analyze the uptake of such an intervention in an urban setting (DS-DOST, powered by Connect for LifeTM, Johnson & Johnson) among different patient groups accessing TB services in New Delhi, India, and subsequently assess its impact in improving patient engagement and treatment outcomes.  This study aims to understand the uptake patterns of a digital adherence technology and its impact in improving follow ups and treatment outcomes among TB patients. Propensity choice modelling was used to create balanced treated and untreated patient datasets, before applying simple ordinary least square and logistic regression methods to estimate the causal impact of the intervention on the number of follow ups made with the patient and treatment outcomes. After controlling for potential confounders, it is found that patients who installed and utilized DS-DOST application received an average of 6.4 (95% C.I. [5.32 to 7.557]) additional follow-ups, relative to those who did not utilize the application. This translates to a 58% increase. They also had 245% higher likelihood of a treatment success (Odds ratio: 3.458; 95% C.I. [1.709 to 6.996]). Descriptive results indicate that young females, and those suffering from pulmonary tuberculosis have a slightly higher propensity to use the CfL™ app, and benefit through their treatment duration.

The authors have declared no competing interest.

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CHAI’s Scientific and Ethical Review Committee (SERC) waived informed consent as anonymized programmatic data was utilized for the study. CHAI’s Scientific and Ethical Review Committee (SERC) waived a formal ethics approval as anonymized programmatic data was utilized for the study. The study was conducted in accordance with relevant guidelines and regulations

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