移动健康技术在改善结核病患者治疗依从性中的应用进展

doi:10.19983/j.issn.2096-8493.20260059

结核与肺部疾病杂志 2026, Vol. 7 Issue (5): 687-693 DOI: 10.19983/j.issn.2096-8493.20260059

移动健康技术在改善结核病患者治疗依从性中的应用进展

张雨豪¹^,², 王丹³, 王姝涵¹^,², 李晨¹^,², 郑婵娟¹^,², 唐文洁³, 阳益德¹^,²(), 龚放华³()

¹ 湖南师范大学公共卫生学院, 长沙 410013
² 分子流行病学湖南省重点实验室, 湖南师范大学, 长沙 410081
³ 湖南省结核病防治所(湖南省胸科医院), 长沙 410006

收稿日期:2026-06-18 出版日期:2026-10-20 发布日期:2026-10-19
通信作者: 阳益德,龚放华 E-mail:yangyide2007@126.com;13787189163@163.com
基金资助:
湖南省胸科医院(湖南师范大学附属胸科医院)—湖南师范大学医学部合作课题(HCHHNU 202506);湖南省大学生创新创业训练计划支持项目(S202610542456)

Mobile health technology for improving treatment adherence in tuberculosis patients: a review

Zhang Yuhao¹^,², Wang Dan³, Wang Shuhan¹^,², Li Chen¹^,², Zheng Chanjuan¹^,², Tang Wenjie³, Yang Yide¹^,²(), Gong Fanghua³()

¹ School of Public Health, Hunan Normal University, Changsha 410013, China
² Key Laboratory of Molecular Epidemiology of Hunan Province, Hunan Normal University, Changsha 410081, China
³ Hunan Institute for Tuberculosis Control (Hunan Chest Hospital), Changsha 410006, China

Received:2026-06-18 Online:2026-10-20 Published:2026-10-19
Contact: Yang Yide,Gong Fanghua E-mail:yangyide2007@126.com;13787189163@163.com
Supported by:
Cooperation Project of Hunan Chest Hospital (Chest Hospital Affiliated to Hunan Normal University) and Hunan Normal University Health Science Center(HCHHNU 202506);Hunan Provincial College Students’ Innovation Training Program(S202610542456)

摘要/Abstract

摘要：

结核病仍是全球主要的传染病死因之一,中国属于30个结核病高负担国家之一。患者治疗依从性差是导致结核病复发和传播的关键因素。依靠传统的医务工作人员直接面视下督导化疗(directly observed treatment,DOT)虽有效,但受人力消耗、交通成本及病耻感等因素限制,难以在资源匮乏地区全面落实。目前,移动健康(mobile health)技术为提升结核病患者治疗依从性提供了新的治疗路径。本文通过对短信提醒服务、视频督导、电话督导、药物监测系统、移动应用程序督导及无线观察疗法等多种移动健康干预方法在改善结核病患者治疗依从性方面的应用进行文献回顾,以期更好地为国内结核病防控工作提供建议。

关键词: 结核, 病例管理, 病人依从, 移动健康, 综述文献(主题)

Abstract:

Tuberculosis (TB) remains one of the leading infectious causes of death worldwide, and China is among the 30 high-burden TB countries globally. Poor treatment adherence constitutes a critical contributor to TB recurrence and transmission. Although the conventional directly observed treatment (DOT) delivered by healthcare workers is effective, its full-scale implementation in resource-limited settings is hindered by massive manpower costs, transportation expenses and disease-related stigma. At present, mobile health technology opens up a novel avenue to improve treatment adherence among TB patients. This paper conducts a literature review on multiple mobile health interventions for enhancing TB treatment adherence, including SMS medication reminders, video-based directly observed treatment, telephone supervision, medication monitoring systems, mobile application-guided supervision and wireless observed therapy, so as to provide evidence-based recommendations for domestic TB prevention and control.

Key words: Tuberculosis, Case management, Patient compliance, Mobile health, Review literature as topic

中图分类号:

张雨豪, 王丹, 王姝涵, 李晨, 郑婵娟, 唐文洁, 阳益德, 龚放华. 移动健康技术在改善结核病患者治疗依从性中的应用进展[J]. 结核与肺部疾病杂志,2026, 7(5): 687-693. doi: 10.19983/j.issn.2096-8493.20260059

Zhang Yuhao, Wang Dan, Wang Shuhan, Li Chen, Zheng Chanjuan, Tang Wenjie, Yang Yide, Gong Fanghua. Mobile health technology for improving treatment adherence in tuberculosis patients: a review[J]. Journal of Tuberculosis and Lung Disease, 2026, 7(5): 687-693. doi: 10.19983/j.issn.2096-8493.20260059

图/表 1

参考文献 49

[1]	World Health Organization. Global tuberculosis report 2025[R]. Geneva: World Health Organization, 2025.
[2]	Kwon S H, Nam J H, Kim H L, et al. Real-world association of adherence with outcomes and economic burden in patients with tuberculosis from South Korea claims data[J]. Front Pharmacol, 2022, 13: 918344. doi:10.3389/fphar.2022.918344.
[3]	Nahid P, Dorman S E, Alipanah N, et al. Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America Clinical Practice Guidelines: Treatment of Drug-Susceptible Tuberculosis[J]. Clin Infect Dis, 2016, 63(7): e147-e195. doi:10.1093/cid/ciw376.
[4]	Eaton C K, McWilliams E, Yablon D, et al. Cross-Cutting mHealth Behavior Change Techniques to Support Treatment Adherence and Self-Management of Complex Medical Conditions: Systematic Review[J]. JMIR Mhealth UHealth, 2024, 12: e49024. doi:10.2196/49024.
[5]	de Groot L M, Straetemans M, Maraba N, et al. Time Trend Analysis of Tuberculosis Treatment While Using Digital Adherence Technologies-An Individual Patient Data Meta-Analysis of Eleven Projects across Ten High Tuberculosis-Burden Countries[J]. Trop Med Infect Dis, 2022, 7(5):65. doi:10.3390/tropicalmed7050065.
[6]	Foppiano Palacios C, Moll A P, Shrestha R, et al. Evaluating community knowledge of tuberculosis preventive therapy in rural South Africa[J]. BMC Public Health, 2025, 25(1): 918. doi:10.1186/s12889-025-21719-2. pmid: 40055618
[7]	殷伟彩, 徐晓曼, 王东昕. 影响肺结核患者服药依从性的相关危险因素[J]. 医学临床研究, 2025, 42(4): 586-589. doi:10.3969/j.issn.1671-7171.2025.04.008.
[8]	Ferreira I B B, Menezes R C, Araújo-Pereira M, et al. Effects of missed anti-tuberculosis therapy doses on treatment outcome: a multi-center cohort study[J]. Lancet Reg Health Am, 2025, 48: 101162. doi:10.1016/j.lana.2025.101162.
[9]	Vega V, Cabrera-Sanchez J, Rodríguez S, et al. Risk factors for pulmonary tuberculosis recurrence, relapse and reinfection: a systematic review and meta-analysis[J]. BMJ Open Respir Res, 2024, 11(1):e002281. doi:10.1136/bmjresp-2023-002281.
[10]	Van Til K, McInnis M G, Cochran A. A comparative study of engagement in mobile and wearable health monitoring for bipolar disorder[J]. Bipolar Disord, 2020, 22(2): 182-190. doi:10.1111/bdi.12849. pmid: 31610074
[11]	Sumari-de Boer M, Pima F M, Ngowi K M, et al. Implementation and effectiveness of evriMED with short messages service (SMS) reminders and tailored feedback compared to standard care on adherence to treatment among tuberculosis patients in Kilimanjaro, Tanzania: proposal for a cluster randomized controlled trial[J]. Trials, 2019, 20(1):426. doi:10.1186/s13063-019-3483-4. pmid: 31300028
[12]	金德兵, 汪全治. 安徽省六安市运用手机短信督导管理肺结核病患者的效果研究[J]. 中国热带医学, 2019, 19(9):872-876. doi:10.13604/j.cnki.46-1064/r.2019.09.15.
[13]	梁大斌, 黄敏莹, 刘飞鹰, 等. 应用手机短信对肺结核患者治疗管理的效果研究[J]. 现代预防医学, 2018, 45(5): 847-850,882.
[14]	方雪晖, 马冬春, 汤莉, 等. 安徽省肺结核患者手机短信管理模式效果研究[J]. 中国预防医学杂志, 2017, 18(12):898-901. doi:10.16506/j.1009-6639.2017.12.005.
[15]	王留苏, 王振平. 电话督导和传统督导方式对肺结核患者治疗管理效果的探讨[J]. 临床医药文献电子杂志, 2019, 6(59): 172,176. doi:10.16281/j.cnki.jocml.2019.59.130.
[16]	朱玉清, 闻俊, 孙馨. 医护患一体化健康教育联合电话随访对肺结核患者治疗依从性及自我效能的影响[J]. 当代护士(下旬刊), 2019, 26(3):166-168.
[17]	石雪梅, 黄秀芳, 廖瑞珍. 探讨医护患面对面的健康教育联合电话随访对初治肺结核患者治疗依从性的影响[J]. 当代医学, 2020, 26(12):171-172. doi:10.3969/j.issn.1009-4393.2020.12.075.
[18]	钱惠军, 步佳佳. 出院电话随访对肺结核患者服药依从性的影响[J]. 当代护士(中旬刊), 2018, 25(2): 124-125.
[19]	皮林敏. 电话督导及随访干预对肺结核患者治疗依从性及临床疗效的影响[J]. 首都食品与医药, 2021, 28(22):110-112. doi:10.3969/j.issn.1005-8257.2021.22.052.
[20]	骆婉霞. 基于微信平台督导的肺功能康复护理在肺结核患者中的应用研究[J]. 中国医药指南, 2024, 22(26):136-138. doi:10.15912/j.issn.1671-8194.2024.26.040.
[21]	Bao Y H, Wang C X, Xu H P, et al. Effects of an mHealth Intervention for Pulmonary Tuberculosis Self-management Based on the Integrated Theory of Health Behavior Change: Randomized Controlled Trial[J]. JMIR Public Health Surveill, 2022, 8(7):e34277. doi:10.2196/34277.
[22]	王卫东. 健康管理对初治肺结核病依从性教育的效果评价[J]. 中国继续医学教育, 2017, 9(20): 191-192. doi:10.3969/j.issn.1674-9308.2017.20.102.
[23]	翁剑峰, 陈文杰, 刘志东, 等. 惠州市基于手机微信APP的结核病管理系统管理模式的实施效果评价[J]. 结核与肺部疾病杂志, 2023, 4(6):468-474. doi:10.19983/j.issn.2096-8493.20230119.
[24]	杨宇. 微信延续性护理模式应用于肺结核患者中的护理效果[J]. 中国社区医师, 2021, 37(21):153-154. doi:10.3969/j.issn.1007-614x.2021.21.075.
[25]	王超, 任剑颖, 胡芳. 打卡小程序联合知信行理论对老年继发性肺结核患者的干预效果[J]. 中国老年学杂志, 2021, 41(22): 5140-5142. doi:10.3969/j.issn.1005-9202.2021.22.076.
[26]	孙清, 宋言峥, 赵亦红. 微信在中青年肺结核患者延续性护理中的应用效果[J]. 当代护士(下旬刊), 2021, 28(12):117-120. doi:10.19793/j.cnki.1006-6411.2021.36.040.
[27]	田军英, 崔晓华, 刘凤娟. 微信小程序健康管理平台对T2DM合并肺结核患者遵医行为及自我护理能力的影响[J]. 临床研究, 2025, 33(10): 160-163. doi:10.12385/j.issn.2096-1278(2025)10-0160-04.
[28]	季丹丹, 林娜. 微信技术对肺结核患者实施健康教育的效果分析[J]. 首都食品与医药, 2021, 28(24):138-139. doi:10.3969/j.issn.1005-8257.2021.24.061.
[29]	秦雪玲, 孙晓英, 陈丽, 等. 微信小程序和电子药盒在肺结核患者督导服药管理中的应用效果[J]. 预防医学论坛, 2025, 31(1): 40-45. doi:10.16406/j.pmt.issn.1672-9153.2025.1.09.
[30]	Li X R, Pang X W, Zhang F. Evaluation of Mobile Application for the Management of Tuberculosis Patients in Tianjin During 2019-2020[J]. Patient Prefer Adherence, 2022, 16: 321-329. doi:10.2147/PPA.S321289.
[31]	Qin N, Chen J, Chen L, et al. Effectiveness of a mobile health application on treatment outcomes among patients with tuberculosis in Shanghai, China: a multicentre randomised controlled trial[J]. BMJ Glob Health, 2025, 10(6):e018022. doi:10.1136/bmjgh-2024-018022.
[32]	Manyazewal T, Woldeamanuel Y, Getinet T, et al. Patient-reported usability and satisfaction with electronic medication event reminder and monitor device for tuberculosis: a multicentre, randomised controlled trial[J]. EclinicalMedicine, 2023, 56:101820. doi:10.1016/j.eclinm.2022.101820.
[33]	Cheng Q, Chen P, Dai R, et al. Comparative Effectiveness of Digital Health Technologies in Tuberculosis Treatment: Systematic Review and Network Meta-Analysis of Randomized Controlled Trials[J]. JMIR Mhealth Uhealth, 2025, 13: e75424. doi:10.2196/75424.
[34]	张晗, 王丽霞, 魏玉石, 等. 数字化治疗依从性技术在肺结核患者服药管理中的应用效果评价[J]. 中国防痨杂志, 2024, 46(2):158-164. doi:10.19982/j.issn.1000-6621.20230283.
[35]	Manyazewal T, Woldeamanuel Y, Holland D P, et al. Effectiveness of a digital medication event reminder and monitor device for patients with tuberculosis (SELFTB): a multicenter randomized controlled trial[J]. BMC Med, 2022, 20(1):310. doi:10.1186/s12916-022-02521-y. pmid: 36167528
[36]	Chen A Z, Kumar R, Baria R K, et al. Impact of the 99DOTS digital adherence technology on tuberculosis treatment outcomes in North India: a pre-post study[J]. BMC Infect Dis, 2023, 23(1):504. doi:10.1186/s12879-023-08418-2. pmid: 37525114
[37]	Kiwanuka N, Kityamuwesi A, Crowder R, et al. Implementation, feasibility, and acceptability of 99DOTS-based supervision of treatment for drug-susceptible TB in Uganda[J]. PLOS Digit Health, 2023, 2(6): e0000138. doi:10.1371/journal.pdig.0000138.
[38]	Garfein R S, Doshi R P. Synchronous and asynchronous video observed therapy (VOT) for tuberculosis treatment adherence monitoring and support[J]. J Clin Tuberc Other Mycobact Dis, 2019, 17: 100098. doi:10.1016/j.jctube.2019.100098.
[39]	中国防痨协会结核病控制专业分会, 中国防痨协会青年分会, 《中国防痨杂志》编辑委员会. 中国结核病数字服药依从性技术应用指南[J]. 中国防痨杂志, 2025, 47(4): 385-397. doi:10.19982/j.issn.1000-6621.20250042.
[40]	王一, 林奕, 张海琳. 微信健康教育方式对耐多药肺结核患者核心知识掌握水平和治疗依从性的影响[J]. 中国医药科学, 2020, 10(4):202-205. doi:10.3969/j.issn.2095-0616.2020.04.060.
[41]	Kumwichar P, Prappre T, Chongsuvivatwong V. Tuberculosis Treatment Compliance Under Smartphone-Based Video-Observed Therapy Versus Community-Based Directly Observed Therapy: Cluster Randomized Controlled Trial[J]. JMIR Mhealth Uhealth, 2024, 12:e53411. doi:10.2196/53411.
[42]	Holzman S B, Zenilman A, Shah M. Advancing Patient-Centered Care in Tuberculosis Management: A Mixed-Methods Appraisal of Video Directly Observed Therapy[J]. Open Forum Infect Dis, 2018, 5(4):ofy046. doi:10.1093/ofid/ofy046.
[43]	Garfein R S, Liu L, Cepeda J, et al. Asynchronous Video Directly Observed Therapy to Monitor Short-Course Latent Tuberculosis Infection Treatment: Results of a Randomized Controlled Trial[J]. Open Forum Infect Dis, 2024, 11(4):ofae180. doi:10.1093/ofid/ofae180.
[44]	Hafezi H, Robertson T L, Moon G D, et al. An ingestible sensor for measuring medication adherence[J]. IEEE Trans Biomed Eng, 2015, 62(1): 99-109. doi:10.1109/TBME.2014.2341272. pmid: 25069107
[45]	Browne S H, Umlauf A, Tucker A J, et al. Wirelessly observed therapy compared to directly observed therapy to confirm and support tuberculosis treatment adherence: A randomized controlled trial[J]. PLoS Med, 2019, 16(10): e1002891. doi:10.1371/journal.pmed.1002891.
[46]	张露露, 高静, 柏丁兮, 等. 移动短信干预对肺结核患者治疗依从性影响的Meta分析[J]. 当代护士, 2022, 29(11): 62-68. doi:10.19791/j.cnki.1006-6411.2022.31.016.
[47]	肖力, 黄亚菊. 短信随访对提高肺结核病人依从性和治愈率的研究[J]. 护士进修杂志, 2014, 29(24):2289-2291. doi:10.16821/j.cnki.hsjx.2014.24.033.
[48]	Zary M, Mohamed M S, Kafie C, et al. The performance of digital technologies for measuring tuberculosis medication adherence: a systematic review[J]. BMJ Glob Health, 2024, 9(7):e015633. doi:10.1136/bmjgh-2024-015633.
[49]	Miladi Q N, Pahria T, Pramukti I. Effectiveness of Digital Health Interventions to Enhance Continuity of Care in Patients with Pulmonary Tuberculosis: A Systematic Review of Randomized Controlled Trials[J]. Patient Prefer Adherence, 2025, 19: 1807-1823. doi:10.2147/PPA.S533210.

技术方法	基础设施依赖度	人群适用性	数据准确性	依从性提升效果
技术方法	基础设施依赖度	人群适用性	数据准确性	治疗依从性指标	干预组	对照组
短信提醒服务^[12-13]	普通手机,无需网络	中青年、文化程度较高者	依赖回复,报告偏倚	服药率	90.6%	56.6%
电话督导^[17-18]	普通手机或座机	县乡镇、偏远地区患者	依赖自述	依从率	96.00%	73.47%
移动应用程序^[24,30]	智能手机+网络	中青年;老年使用率低	主动打卡,可多次提醒	治疗依从性	98%	66%
药物监测系统^[34-36]	药盒需网络或USB接口;99DOTS仅需电话	老年患者偏好显著	开盒拨号,但过度报告	服药率	95.89%	92.37%
视频观察疗法^[40-41]	智能手机+稳定网络	有智能手机、能操作视频者	实时视频证据	治疗依从性时间差异	15.2(95%CI: 4.8~25.6)d^a
无线观察疗法^[45]	摄入传感器+贴片+移动设备	愿意佩戴、无皮肤过敏者	客观摄入验证	治疗依从性	93%	63%

移动健康技术在改善结核病患者治疗依从性中的应用进展

Mobile health technology for improving treatment adherence in tuberculosis patients: a review

RichHTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

图/表 1

参考文献 49

相关文章 15

编辑推荐

Metrics

本文评价

[1]	马志明. 《尘肺病合并肺结核诊治中国专家共识》解读[J]. 结核与肺部疾病杂志, 2026, 7(5): 559-563.
[2]	聂礼刚, 张明悦, 阿米那·马木提, 王雪钰, 卢水华, 聂文娟. B-P-L-S-Z超短程方案治疗利福平耐药结核病的单臂可行性研究设计[J]. 结核与肺部疾病杂志, 2026, 7(5): 568-573.
[3]	曾春梅, 卢青霞, 聂文娟, 朱庆东, 初乃惠, 朱凤梅. 口服舒达吡啶(WX-081)片对初治药物敏感肺结核和耐药肺结核早期杀菌活性、安全性和耐受性的Ⅱ期临床研究[J]. 结核与肺部疾病杂志, 2026, 7(5): 574-580.
[4]	易本菊, 唐逾鸿, 莫沂鑫, 江莉娜, 廖懿. 重庆市合川区活动性肺结核患者家庭密切接触者结核感染状况及相关因素分析[J]. 结核与肺部疾病杂志, 2026, 7(5): 581-588.
[5]	庞艳, 吴成果, 汪清雅, 彭朋. 2021—2024年重庆市肺结核患者服药依从性及影响因素研究[J]. 结核与肺部疾病杂志, 2026, 7(5): 589-595.
[6]	李盈盈, 任艳. 肾上腺结核相关肾上腺皮质功能减退症的研究进展[J]. 结核与肺部疾病杂志, 2026, 7(5): 665-672.
[7]	潘丽华, 詹璐. 尿液脂阿拉伯甘露聚糖检测对儿童结核病诊断价值的研究进展[J]. 结核与肺部疾病杂志, 2026, 7(5): 673-678.
[8]	江萍, 李天驹, 康光鸿, 向明确. 结核分枝杆菌潜伏感染防控策略的研究进展[J]. 结核与肺部疾病杂志, 2026, 7(5): 679-686.
[9]	陈石芬, 浦仕莽, 张云桂, 何朝庭, 杨艳, 司迎燕. B-Pa-L-M全口服短程方案治疗耐多药结核病二例[J]. 结核与肺部疾病杂志, 2026, 7(5): 708-711.
[10]	马志明, 周晓婷. 8号染色体三体相关骨髓增生异常综合征合并播散性堪萨斯分枝杆菌病及继发性肺泡蛋白沉积症一例并文献复习[J]. 结核与肺部疾病杂志, 2026, 7(5): 712-716.
[11]	中国卫生监督协会. T/WSJD 31—2023 尘肺合并肺结核胸部影像学诊断指南[J]. 结核与肺部疾病杂志, 2026, 7(4): 415-421.
[12]	王焕强. 《T/WSJD 31—2023 尘肺合并肺结核胸部影像学诊断指南》团体标准解读[J]. 结核与肺部疾病杂志, 2026, 7(4): 422-425.
[13]	魏云霞, 王鑫, 龙雪娟, 李宁, 桑珍珍. 血清C-反应蛋白和D-二聚体水平对危重症肺结核患者预后的预测价值[J]. 结核与肺部疾病杂志, 2026, 7(4): 448-453.
[14]	高芬, 张倬, 李倩, 唐晓林, 方喆. 新型冠状病毒感染合并肺结核患者的临床特点分析[J]. 结核与肺部疾病杂志, 2026, 7(4): 462-468.
[15]	郑庆铭. 2020—2024年福建省莆田市秀屿区肺结核流行病学特征分析[J]. 结核与肺部疾病杂志, 2026, 7(4): 469-473.