[Comment] Rethinking the benefits of digital adherence technologies for tuberculosis treatment

Poor treatment adherence remains a major obstacle in national tuberculosis programmes globally. Digital adherence technologies offer novel opportunities to monitor and address poor adherence. Research shows that adherence challenges are common under programmatic conditions, vary among patient subgroups, and worsen over the course of treatment.1,2 Patterns of poor adherence range from missed doses and irregular treatment to discontinuation of treatment.2 Although digital adherence technologies can improve adherence through patient reminders and better monitoring, assessing their impact is challenging due to the Hawthorne effect3 and difficulties in measuring adherence in control groups without digital adherence technologies.