Intervensi digital, peran pengawas minum obat (PMO), dan pendekatan psikososial dalam meningkatkan kepatuhan pengobatan tuberkulosis: Literature review
DOI: https://doi.org/10.56922/quilt.v6i8.2713
Community Empowerment Digital Health Psychosocial Interventions Treatment Adherence Treatment Supporters Tuberculosis
Abstract
Background: Tuberculosis (TB) remains a major global public health challenge, particularly in low- and middle-income countries, where suboptimal treatment adherence continues to hinder therapeutic success. Non-adherence contributes to treatment failure, drug resistance, relapse, and ongoing community transmission.
Purpose: To synthesize scientific evidence on the effectiveness of digital interventions, the role of Medication Supervisors (PMOs), and psychosocial and community empowerment approaches in improving TB treatment adherence and success.
Method: A narrative structured review guided by systematic review principles was conducted, including 28 studies published between 2016 and 2025.
Results: The findings indicate that digital interventions—such as SMS reminders, video-observed therapy, and mobile health applications—enhance adherence through reminders, patient education, monitoring, and improved communication; however, their impact on clinical outcomes remains moderate and implementation-dependent. Conversely, treatment supporters, family engagement, and community participation play a pivotal role in sustaining adherence, strengthening patient motivation, and improving quality of life. Psychosocial and community-based strategies further reinforce medical interventions by reducing stigma, improving health literacy, and establishing sustainable social support networks.
Conclusion: Overall, improving TB treatment adherence and outcomes requires a multidimensional and context-specific approach integrating digital health technologies, strengthened treatment support systems, and psychosocial and community-level interventions.
Keywords: Community Empowerment; Digital Health; Psychosocial Interventions; Tuberculosis; Treatment Adherence; Treatment Supporters.
Downloads
References
Abas, S. A., Ismail, N., Zakaria, Y., Yasin, S. M., Ibrahim, K., Ismail, I., Razali, A., Sherzkawi, M. A., & Ahmad, N. (2024). Enhancing Tuberculosis Treatment Adherence and Motivation Through Gamified Real-Time Mobile App Utilization: A Single-Arm Intervention Study. BMC Public Health, 24(1), 249.
Addo, J., Pearce, D., Metcalf, M., Lundquist, C., Thomas, G., Barros-Aguirre, D., Koh, G. C. K. W., & Strange, M. (2022). Living with Tuberculosis: A Qualitative Study of Patients’ Experiences with Disease and Treatment. BMC Public Health, 22(1), 1717.
Alipanah, N., Jarlsberg, L., Miller, C., Linh, N. N., Falzon, D., Jaramillo, E., & Nahid, P. (2018). Adherence Interventions and Outcomes of Tuberculosis Treatment: A Systematic Review and Meta-Analysis of Trials and Observational Studies. PLoS Medicine, 15(7), e1002595.
Anggiani, S., Safariyah, E., & Novryanthi, D. (2023). Hubungan Pengawas Menelan Obat (PMO) dengan kepatuhan minum obat pada pasien tuberkulosis paru di Puskesmas Kayu Manis Kota Bogor. Journal of Public Health Innovation, 4(01), 84–92.
Burzynski, J., Mangan, J. M., Lam, C. K., Macaraig, M., Salerno, M. M., DeCastro, B. R., Goswami, N. D., Lin, C. Y., Schluger, N. W., & Vernon, A. (2022). In-Person vs Electronic Directly Observed Therapy for Tuberculosis Treatment Adherence: A Randomized Noninferiority Trial. JAMA Network Open, 5(1), e2144210–e2144210.
Datiko, D. G., Habte, D., Jerene, D., & Suarez, P. (2019). Knowledge, Attitudes, and Practices Related to TB Among the General Population of Ethiopia: Findings from A National Cross-Sectional Survey. PloS One, 14(10), e0224196.
Febrina, W. (2018). Analisis Peran Keluarga sebagai Pengawas Minum Obat (PMO) Pasien TB Paru. Human Care Journal, 3(2), 118–129.
Indawati, E., Kosasih, C. E., Haroen, H., & Anna, A. (2025). Technology-Integrated Nursing Interventions to Improve Adherence to Tuberculosis Medication: A Scoping Review. BMC Nursing, 24(1), 1160.
Iribarren, S. J., Milligan, H., Chirico, C., Goodwin, K., Schnall, R., Telles, H., Iannizzotto, A., Sanjurjo, M., Lutz, B. R., & Pike, K. (2022). Patient-Centered Mobile Tuberculosis Treatment Support Tools (TB-TSTs) to Improve Treatment Adherence: A Pilot Randomized Controlled Trial Exploring Feasibility, Acceptability and Refinement Needs. The Lancet Regional Health–Americas, 13.
Kaplan, R., Caldwell, J., Hermans, S., Adriaanse, S., Mtwisha, L., Bekker, L. G., Jennings, K., & Wood, R. (2016). An Integrated Community TB-HIV Adherence Model Provides an Alternative to DOT for Tuberculosis Patients in Cape Town. The International Journal of Tuberculosis and Lung Disease, 20(9), 1185–1191.
Krishnan, L., Akande, T., Shankar, A. V, McIntire, K. N., Gounder, C. R., Gupta, A., & Yang, W.-T. (2014). Gender‐Related Barriers and Delays in Accessing Tuberculosis Diagnostic and Treatment Services: A Systematic Review of Qualitative Studies. Tuberculosis Research and Treatment, 2014(1), 215059.
Kurniasih, E., & Sa’adah, H. D. (2017). Pengaruh Peran Pengawas Menelan Obat (PMO) dengan Kepatuhan Minum Obat Pasien Tuberkulosis Paru di Wilayah Kerja Puskesmas Ngawi Kabupaten Ngawi. Warta Bhakti Husada Mulia: Jurnal Kesehatan, 4(2).
Lestari, D. A., Karim, A., & Pirmansyah, M. T. (2023). Hubungan Peran Keluarga sebagai Pengawas Minum Obat (PMO) dengan Kepatuhan Minum Obat pada Penderita Tuberkulosis di Wilayah Kerja Puskesmas Cisoka Tahun 2022. Jurnal Penelitian Keperawatan, 9(2), 147–153.
Maesaroh, I., & Nurjannah, N. (2019). Peranan Pengawasan Minum Obat (PMO) terhadap Keberhasilan Pengobatan TB Paru. Jurnal Ilmiah Kesehatan, 8(2), 56–63.
Mair, F. S., Montori, V. M., & May, C. R. (2021). Digital Transformation Could Increase the Burden of Treatment on Patients. In bmj (Vol. 375). British Medical Journal Publishing Group.
Marito, L. P., & Siti Zahara Nasution, F. S. (2023). Peningkatan Kualitas Hidup Pasien Tuberkulosis dengan Pemantauan Peran Pengawas Minum Obat (PMO). Journal of Telenursing (JOTING), 5(2), 2110–2119.
Meira, O. O., Silva, L. G. R., Sales, R. F., Colodette, R. M., Pinto, L. B. G. F., Ferreira, E. de S., Cotta, R. M. M., & Moreira, T. R. (2025). Effects of Communication Strategies on Treatment Adherence and Success in Tuberculosis: A Systematic Review and Meta‐Analysis. Tropical Medicine & International Health, 30(10), 1053–1068.
Mohammed, S., Glennerster, R., & Khan, A. J. (2016). Impact of a Daily SMS Medication Reminder System on Tuberculosis Treatment Outcomes: A Randomized Controlled Trial. PloS One, 11(11), e0162944.
Moyo, T. M., Sibanda, E., Gombe, N. T., Juru, T. P., Govha, E., Omondi, M., Chadambuka, A., & Tshimanga, M. (2022). Secondary Data Analysis of Tuberculosis Deaths in Bulawayo Province, Zimbabwe, 2016-2019. Open Journal of Epidemiology, 12(1), 57–67.
Naidoo, P., Peltzer, K., Louw, J., Matseke, G., Mchunu, G., & Tutshana, B. (2013). Predictors of Tuberculosis (TB) and Antiretroviral (ARV) Medication Non-Adherence in Public Primary Care Patients in South Africa: A Cross Sectional Study. BMC Public Health, 13(1), 396.
Ngoc, N. B., Vu Dinh, H., Thuy, N. T., Quang, D. Van, Huyen, C. T. T., Hoa, N. M., Anh, N. H., Dat, P. T., Hoa, N. B., & Tiemersma, E. (2021). Active Surveillance for Adverse Events in Patients on Longer Treatment Regimens for Multidrug-Resistant Tuberculosis in Viet Nam. PLoS One, 16(9), e0255357.
Otoo, D. M., Efichie, E., Aborbor, D. L., Okudzeto, H., Asabekah, G. L., Akila, D. A., & Hagan, N. (2025). Understanding Predictors of Medication Adherence and Treatment Outcomes Among TB Patients in the Western Region, Ghana: Strategies for Strengthening TB Control Efforts. Journal of Health, Population and Nutrition, 44(1), 407.
Pantoja, T., Opiyo, N., Lewin, S., Paulsen, E., Ciapponi, A., Wiysonge, C. S., Herrera, C. A., Rada, G., Penaloza, B., & Dudley, L. (2017). Implementation Strategies for Health Systems in Low‐Income Countries: An Overview of Systematic Reviews. Cochrane Database of Systematic Reviews, 9.
Permatasari, P. A. I. (2020). Hubungan Antara Peran Pengawas Menelan Obat dengan Kepatuhan Penderita Mengkonsumsi Obat Anti Tuberculosis di Denpasar Selatan. Jurnal Riset Kesehatan Nasional, 4(1), 65–69.
Pradipta, I. S., Houtsma, D., van Boven, J. F. M., Alffenaar, J.-W. C., & Hak, E. (2020). Interventions to Improve Medication Adherence in Tuberculosis Patients: A Systematic Review of Randomized Controlled Studies. NPJ Primary Care Respiratory Medicine, 30(1), 21.
Ratnasari, R. (2023). Hubungan Peran Orangtua Sebagai Pengawas Minum Obat (PMO) dengan Kepatuhan Minum Obat pada Anak dengan Tuberkulosis. Open Access Jakarta Journal of Health Sciences, 2(5), 702–707.
Ridho, A., Alfian, S. D., van Boven, J. F. M., Levita, J., Yalcin, E. A., Le, L., Alffenaar, J.-W., Hak, E., Abdulah, R., & Pradipta, I. S. (2022). Digital Health Technologies to Improve Medication Adherence and Treatment Outcomes in Patients with Tuberculosis: Systematic Review of Randomized Controlled Trials. Journal of Medical Internet Research, 24(2), e33062.
Roberti, J., Morelli, D. M., Aguilar-Vidrio, O. A., Suyanto, A., Carmiol-Rodriguez, P., Tolentino, A., Chen-Liang, E., Sprecher, J., Rubinstein, F., & Iribarren, S. (2025). Improving Tuberculosis Treatment Adherence: A Qualitative Study of Patients’ Perspectives from A Pragmatic Trial of the Tuberculosis Treatment Support Tools Intervention. Bmj Open, 15(9), e095878.
Santosa, A., Juniarti, N., Pahria, T., & Susanti, R. D. (2025). Digital Adherence Technology to Improve Medication Adherence in Tuberculosis Patients: A Systematic Review and Meta-Analysis Randomized Control Trials. Npj Primary Care Respiratory Medicine, 35(1), 52.
Sazali, M. F., Rahim, S. S. S. A., Mohammad, A. H., Kadir, F., Payus, A. O., Avoi, R., Jeffree, M. S., Omar, A., Ibrahim, M. Y., & Atil, A. (2022). Improving Tuberculosis Medication Adherence: the Potential of Integrating Digital Technology and Health Belief Model. Tuberculosis and Respiratory Diseases, 86(2), 82.
Story, A., Aldridge, R. W., Smith, C. M., Garber, E., Hall, J., Ferenando, G., Possas, L., Hemming, S., Wurie, F., & Luchenski, S. (2019). Smartphone-Enabled Video-Observed Versus Directly Observed Treatment for Tuberculosis: A Multicentre, Analyst-Blinded, Randomised, Controlled Superiority Trial. The Lancet, 393(10177), 1216–1224.
Suarni, E., Rizki, P., Badri, A., & Hidayah, A. A. (2023). Peran PMO dan Analisis Tingkat Kepatuhan Menelan Obat pada Pasien Tuberkulosis Paru di Puskesmas Palembang: Dampak terhadap Kesembuhan. Jurnal Ners, 7(2), 1121–1127.
Subbaraman, R., de Mondesert, L., Musiimenta, A., Pai, M., Mayer, K. H., Thomas, B. E., & Haberer, J. (2018). Digital Adherence Technologies for the Management of Tuberculosis Therapy: Mapping the Landscape and Research Priorities. BMJ Global Health, 3(5), e001018.
Surati, S., Auliya, Q. A., Priyatno, D., Kahar, F., & Nastiti, H. R. R. (2024). Pemberdayaan Masyarakat sebagai Pengawas Menelan Obat (PMO) untuk Meningkatkan Kepatuhan Minum Obat Pasien Tuberkulosis di Kelurahan Bangetayu Wetan Kecamatan Genuk Kota Semarang. Jurnal Abdi Masyarakat Indonesia, 4(5), 1441–1446.
Teferi, M. Y., El-Khatib, Z., Boltena, M. T., Andualem, A. T., Asamoah, B. O., Biru, M., & Adane, H. T. (2021). Tuberculosis Treatment Outcome and Predictors in Africa: A Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health, 18(20), 10678.
Triyani, R., & Rizal, A. (2025). Hubungan Peran Pengawas Menelan Obat (PMO) dengan Kepatuhan Minum Obat pada Pasien Tuberculosis Paru. Jurnal Ilmiah Keperawatan (Scientific Journal of Nursing), 11(3), 531–539.
World Health Organization. (2018). Global Tuberculosis Report 2018. World Health Organization. Diakses dari: https://www.who.int/publications/i/item/9789241565646
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Indah Mutia, Andi Alim, Ishaq Iskandar
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
