EFFECTIVENESS OF HEALTH EDUCATION MODULE DELIVERED THROUGH WHATSAPP TO ENHANCE TREATMENT ADHERENCE AND SUCCESSFUL OUTCOME OF TUBERCULOSIS IN SEREMBAN DISTRICT, NEGERI SEMBILAN, MALAYSIA

Introduction: Health education and awareness program have shown to be the factor that promote adherence behaviour and successful outcome of tuberculosis (TB). Mobile health (mHealth) initiative that utilize WhatsApp may help in achieving health objectives. Aims: This study aimed to determine the effectiveness of Health Education Module named TB@Clicks delivered through WhatsApp to enhance treatment adherence and successful outcome among pulmonary tuberculosis (PTB) patients. Methodology: A randomized controlled trial was done among all newly diagnosed TB cases registered in Seremban District between 1st of July 2017 until 9th of April 2018. The patients who fulfils the eligibility criteria were systematically selected and randomly assigned to receive TB@Clicks module through WhatsApp or continue with the existing conventional health education. The respondents were followed-up until treatment was completed. The estimated total sample size was 110. Adherence rate and treatment outcome were gathered from the record book in Health Clinics. Multivariate statistical analysis was conducted to determine the effectiveness of intervention on both outcomes. Result: A total of 110 PTB patients were recruited and 93 patients retained in the study (84.5%). Among them, 50 (90.9%) was from intervention group and 43 (78.2%) was from control group. There were 81.8% of respondents who received intervention adhered to TB treatment and 85.5% has the successful treatment outcome as compared to only 69.1% adherence and 70.9% with treatment success in control group but both were not statistically significant (p=0.121 & p=0.065). In multivariate analyses performed using generalized linear mixed models, PTB patients who had received intervention was 4.1 (95% CI = 1.16-14.87) times as likely to had successful treatment outcome as patients who had not received intervention. Conclusion: The TB@Clicks intervention module delivered through WhatsApp was effectively enhanced the treatment success rate but no significant effects on the adherence rate among PTB patients. Keywords: Pulmonary tuberculosis, mHealth, medication adherence