Evidence map›Paper›PMID 35165113›Full record

Trial reportBMJ open2022

Effect of a brief motivational interview and text message intervention targeting tobacco smoking, alcohol use and medication adherence to improve tuberculosis treatment outcomes in adult patients with tuberculosis: a multicentre, randomised controlled trial of the ProLife programme in South Africa.

Goedele Louwagie, Mona Kanaan, Neo Keitumetse Morojele, Andre Van Zyl, Andrew Stephen Moriarty, Jinshuo Li, Kamran Siddiqi, Astrid Turner, Noreen Dadirai Mdege, Olufemi Babatunde Omole and 4 more

Open access · goldAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 6 pooled it
12.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 6 syntheses or guidelines pooled it, 47 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 6 institutions in 2 countries.

Goedele LouwagieResearch, Postgraduate Studies and Innovation, Sefako Makgatho Health Sciences University, Pretoria, South Africa Goedele.louwagie@up.ac.za.ORCID 0000-0002-4384-2318
Mona KanaanDepartment of Health Sciences, University of York, York, UK.
Neo Keitumetse MorojeleDepartment of Psychology, University of Johannesburg, Auckland Park, South Africa.
Andre Van ZylResearch, Postgraduate Studies and Innovation, Sefako Makgatho Health Sciences University, Pretoria, South Africa.ORCID 0000-0001-6872-5276
Andrew Stephen MoriartyDepartment of Health Sciences and the Hull York Medical School, University of York, York, UK.ORCID 0000-0003-0770-3262
Jinshuo LiDepartment of Health Sciences, University of York, York, UK.ORCID 0000-0003-1496-7450
Kamran SiddiqiDepartment of Health Sciences and the Hull York Medical School, University of York, York, UK.ORCID 0000-0003-1529-7778
Astrid TurnerSchool of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa.
Noreen Dadirai MdegeDepartment of Health Sciences, University of York, York, UK.
Olufemi Babatunde OmoleDepartment of Family Medicine, University of the Witwatersrand, Johannesburg-Braamfontein, South Africa.
John TumboDepartment of Family Medicine, Sefako Makgatho Health Sciences University, Pretoria, South Africa.
Max BachmannNorwich Medical School, University of East Anglia, Norwich, UK.ORCID 0000-0003-1770-3506
Steve ParrottDepartment of Health Sciences, University of York, York, UK.
Olalekan A Ayo-YusufSchool of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa.
University of York · GBSefako Makgatho Health Sciences University · ZASouth African Medical Research Council · ZAUniversity of East Anglia · GBUniversity of Pretoria · ZAUniversity of the Witwatersrand · ZA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo investigate the effectiveness of a complex behavioural intervention, ProLife, on tuberculosis (TB) treatment success, medication adherence, alcohol use and tobacco smoking.

designMulticentre, individual, randomised controlled trial where participants were assigned (1:1) to the ProLife intervention or usual care.

setting27 primary care clinics in South Africa.

participants574 adults starting treatment for drug-sensitive pulmonary TB who smoked tobacco or reported harmful/hazardous alcohol use.

interventionsThe intervention, delivered by lay health workers (LHWs), consisted of three brief motivational interviewing (MI) sessions, augmented with short message service (SMS) messages, targeting medication adherence, alcohol use and tobacco smoking. OUTCOME MEASURES: The primary outcome was successful versus unsuccessful TB treatment at 6-9 months, from TB records. Secondary outcomes were biochemically confirmed sustained smoking cessation, reduction in the Alcohol Use Disorder Identification Test (AUDIT) score, improved TB and antiretroviral therapy (ART) adherence and ART initiation, each measured at 3 and 6 months by questionnaires; and cure rates in patients who had bacteriology-confirmed TB at baseline, from TB records.

resultsBetween 15 November 2018 and 31 August 2019, 574 participants were randomised to receive either the intervention (n=283) or usual care (n=291). TB treatment success rates did not differ significantly between intervention (67.8%) and control (70.1%; OR 0.9, 95% CI 0.64% to 1.27%). There was no evidence of an effect at 3 and 6 months, respectively, on continuous smoking abstinence (OR 0.65, 95% CI 0.37 to 1.14; OR 0.76, 95% CI 0.35 to 1.63), TB medication adherence (OR 1.22, 95% CI 0.52 to 2.87; OR 0.89, 95% CI 0.26 to 3.07), taking ART (OR 0.79, 95% CI 0.38 to 1.65; OR 2.05, 95% CI 0.80 to 5.27) or AUDIT scores (mean score difference 0.55, 95% CI -1.01 to 2.11; -0.04, 95% CI -2.0 to 1.91) and adjusting for baseline values. Cure rates were not significantly higher (OR 1.16, 95% CI 0.83 to 1.63).

conclusionsSimultaneous targeting of multiple health risk behaviours with MI and SMS using LHWs may not be an effective approach to improve TB outcomes. TRIAL REGISTRATION NUMBER: ISRCTN62728852.

Indexed as

HIV InfectionsMotivational InterviewingText MessagingTuberculosisAdultHumansMedication AdherenceSouth AfricaTobacco SmokingTreatment Outcomehealth economicsHIV & AIDSorganisation of health servicespublic healthsubstance misusetuberculosis

Identifiers

PMID35165113
PMCPMC8845202
OpenAlexW4212808479

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.