تعليقThere is a need to improve the quality of patient data using standardized variables, such as data on DST patterns, prescribed treatment, treatment outcomes and adverse drug reactions. The collection and utility of these data are important for future evidence-based recommendations, especially given the lack of RCTs on the management of DR-TB (126). If digital patient records do not already exist, it is important that the programme managers consider their introduction, at least for surveillance and possibly also for case management (146). If patient records are already digital, changes may be needed in the electronic recording and reporting system to allow individuals belonging to MDR-TB regimen cohorts of interest (e.g. shorter regimen, bedaquiline-containing regimens and operational research subgroups) to be identifiable, and for certain options to be included in the monitoring framework (e.g. addition of clofazimine and registration of ECG findings). It is crucial for programmes to maintain such data diligently and prospectively, so that they can contribute to programme evaluation and to global policy-making (e.g. the development of the WHO consolidated guidelines benefited hugely from the experience of patient treatment within programmes) (123, 124). The treatment outcome cohort reports for MDR/RR-TB do not need to change (for the digital and paper version). Moreover, electronic tools can enhance the quantification of consumables; for example, volumes of medicine can be calculated automatically using QuanTB, an application (app) that is available for download free of charge.12 It is important to ensure that digital records can accommodate key measures in children that may differ from those for adults.
12 Available at https://siapsprogram.org/tools-and-guidance/quantb/.