Patient centered and technology enabled strategies to improve Tuberculosis treatment adherence

INTRODUCTION: Tuberculosis (TB) treatment adherence (how regular patients follow the prescribed medication) has a major role in TB control. In high burden countries such as India, poor adherence contributes to treatment failure, relapse and the emergence of drug-resistant TB (DR-TB), despite substantial programmatic efforts to improve treatment outcomes. AREAS COVERED: This review examines a broad range of TB treatment adherence strategies, including digital adherence technologies, behavioral and psychosocial interventions, directly observed therapy models, medication dispensing and monitoring tools, incentive based support programs and emerging artificial intelligence and biometric approaches. Evidence from published literature were searched in PubMed and Google Scholar and synthesized. EXPERT OPINION: This review highlights that digital adherence strategies could reduce cost, travel and time by making adherence monitoring more efficient and less resource intensive for both patient and providers. This could complement existing adherence strategies in the programme. Multicomponent strategies that combine real time adherence monitoring, counseling, community engagement and social support are likely to be most effective in sustaining adherence, preventing drug resistance and advancing progress toward TB elimination.