Treatment made easier for tuberculosis patients

The rising tuberculosis-related mortality rate

Tuberculosis (TB) is fatal disease with a high death rate in India and fighting it requires consuming medicines with time-bound precision. Consuming treatment drug(s) erratically, leads to the disease progresses to an even more challenging drug-resistant stage.  

In 2016 alone, India saw nearly 423,000 deaths due to TB, with disease incidence being seven times that figure—the highest in the world. Despite its best efforts, the country is struggling to make a dent in TB morbidity statistics, with one of the main reasons being the lack of treatment adherence.

A team groomed by TCS’ Digital Impact Square (DISQ) has brought some respite to TB patients by building a fully indigenous, scale ready IoT-based pill dispenser, called TMEAD, to enhance adherence outcomes and provide prioritized attention to healthcare workers.  
 
The device built by Nishad Halkarni and Rahul Doshi, product developers from the DISQ team, adheres to the National Tuberculosis Elimination Programme (NTEP)—a critical initiative to stall the spread of the disease—and improves the dosage and monitors the process involved.

Innovation through automation  
  
NTEP depends on manual pill dispensing for compliance and recording of treatment procedures, and it was observed that the information gathered about treatment adherence was often unreliable and open to manipulation. Since tracking and preventing missed doses is crucial to the treatment, the team designed TMEAD to be able to alert patients to take their medicines.

Depending on how long it has been since the last dose, the device follows an escalation matrix to alert caregivers, health workers, and eventually, the district administration. Apart from regime monitoring and avoiding interruptions in treatment, this solution also helps map disease analytics in real time.  

Acceptance and results  
  
The TMEAD team has secured a grant from the India Health Fund to run a multi-state pilot, covering around 800 of drug sensitive and drug resistant patients across the Indian states of Maharashtra and Gujarat. They are also undergoing clinical validation trial from the Indian Institute of Public Health, Gandhinagar.  
  
Of course, this task was not without its challenges, starting from the fact that the pills in the dispenser need to be tamper-proof and blister packed, and should last a fortnight at least so that patients don’t have to keep travelling for refills. The device also needed to pack in enough battery power for a month, while still blending in at the patients’ homes to prevent further stigma.