Smartphone Applications to Support Tuberculosis Prevention and Treatment: Review and Evaluation

Purpose: According to the World Health Organization, globally there are over 14 million active cases, 9 million newly diagnosed, and 1.5 million deaths attributable to Tuberculosis (TB) annually.(WHO, 2014) Smartphone applications (apps) have been suggested as potential tools to support TB control efforts.(Denkinger et al, 2013, Iribarren, 2014) The purpose of this review was to identify and assess the functionalities of mobile apps focused on TB prevention and treatment.

Methods: We searched 3 online mobile app stores. Apps were included if they were focused on TB and were in English, Spanish, or Portuguese. For each included app, 11 functionalities were assessed (e.g., inform, instruct, record) and searches were conducted to identify published testing results.(IMS Institute, 2015, Hale, 2015). Grey literature was also searched for apps in development.

Results: 1332 potentially relevant apps were identified, with 24 meeting our inclusion criteria. All of the apps were free to download, but 7 required login and password and were developed for specific clinics, regional sites, or research studies. Targeted users were mainly clinicians (n = 17); few (n = 4) apps were patient focused. Most apps (n=17) had a total of 4 or fewer functions out of 11 (range 1-6). The most common functionalities were inform and record (n=15). Although a number of apps were identified with various functionalities to support TB efforts, some had issues, such as incorrect spelling and grammar, inconsistent responses to data entry, problems with crashing, or links to features that had no data. Eight apps had not been updated for more than a year and may no longer be supported. Peer reviewed publications were identified for only two of the included apps. Three TB related apps were identified in the grey literature (not found in the app stores) as in progress, being launched, or tested.

Conclusion: These results suggest that  current TB apps  have minimal functionality, primarily target healthcare workers, and focus on information (e.g., general, guidelines, and news) or data collection (e.g., replace paper-based notification or tracking). None were developed to support patients’ involvement and management in their care (e.g., follow-up alerts/reminders, side effects monitoring), or to improve interaction with their healthcare providers, which limits the potential of these apps to facilitate patient-centered care. Given the complexity and challenges faced by patients with TB, there is a need for app development targeting their needs. Involving TB patients in the design of these apps is recommended.