New app launched for nurses to manage side effects to drug-resistant tuberculosis treatment to improve quality care for patients

24 June 2020

The International Council of Nurses (ICN) today announced the launch of the ICN and Curry International TB Center (CITC) mobile app of the Nursing Guide for Managing Side Effects to Drug-resistant TB Treatment.

This ICN/CITC guide was developed in 2018 by nurses with experience in the clinical care and programmatic management of tuberculosis (TB) and drug-resistant tuberculosis (DR-TB) in both high- and low-resource settings. Nursing and DR-TB literature were reviewed to establish best practice nursing assessment and intervention guidance. More than 200 nurses caring for patients with DR-TB field-tested the guide in 11 countries and provided very favourable feedback confirming its broad applicability worldwide. Their feedback was used to inform the final content and format of the guide and this app.

ICN President Annette Kennedy said:

“Side effects to DR-TB treatment can be unpleasant and debilitating and often lead to patients stopping treatment. Nurses are uniquely placed to identify potential side effects and this guide enables nurses to identify them early, intervene and improve patient care. Having this guide now as a mobile app will increase access to this useful tool, improve patient care and help patients continue treatment to a cure.”

Dr Carrie Tudor, Director of ICN’s TB/MDR-TB project said, “The guide is a practical resource for nurses in inpatient, clinic and community settings who are caring for patients with DR-TB. It helps them to identify potential side effects and provides suggestions for nursing assessments and interventions to minimise the side effects to treatment. Now this resource is available as a handy app that nurses can access on a smartphone.”

Patients on treatment for DR-TB face many challenges, most notably difficult side effects, such as nausea, hearing loss, and fatigue. These side effects impact the patient’s quality of life, capacity to work, and ability to continue activities of daily living. Medication side effects have been cited as a major factor linked to patients stopping treatment. The 2019 WHO Global TB Report noted with alarm that only 56% of patients with DR-TB successfully complete treatment.

According to CITC Associate Medical Director Ann Raftery, RN, PHN, MS: “Nurses commonly see DR-TB patients daily for treatment delivery and monitoring. They are often the first to hear of a patient’s side effects during treatment. With this guide as a resource, nurses are empowered to help their patients.”

The app is designed as a reference, so nurses can quickly: 1) identify symptoms that may indicate a side effect related to DR-TB treatment or antiretroviral medication; 2) assess for severity as well as other potential contributors; and 3) intervene appropriately to minimise patient discomfort, reduce side effect progression, and ultimately support successful treatment completion.

Nurses who field-tested the app praised its content and ease of use: “It is so clear and easy to follow”. A nurse from Zambia said: “The appearance is good, and the content is appropriate and relevant. It is easy to maneuver between content, which is good. I know it will help a lot of nurses, especially nurses working with MDR-TB patients and those working with HIV patients. We now have nurses who have the specific job of following MDR-TB patients in the community, this app will be a wonderful tool.” A nurse from the United States reported: “I love having this reference as an app. It was easy to use, and I will be recommending it to my colleagues. I used it for my non-MDR patient, so it’s applicable to all TB patients.”

The guide is available in English, Russian, Chinese, French, Spanish, Portuguese and Indonesian (Bahasa), and can be downloaded now from the ICN website at and the Curry International TB Center website at

The app is currently available in English and is available on both Google Play and the Apple App store. ICN’s MDR-TB project aims to build global nursing capacity in the prevention, care and treatment of TB. This is achieved by training experienced nurses to cascade information to nursing colleagues and other health workers with the purpose of making improvements to patient care delivery. The development of this app was supported by the Stop TB Partnership’s TB REACH initiative funded by the Government of Canada and the Bill & Melinda Gates Foundation.

To download the press release please click here.