Development of a Video-Observed Therapy System to Improve Monitoring of Tuberculosis Treatment in Thailand: Mixed-Methods Study

Kumwichar, Ponlagrit; Chongsuvivatwong, Virasakdi; Prappre, Tagoon

doi:10.2196/29463

Cited by 14 publications

(32 citation statements)

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“…The results show that the observers who used the actual and simulated VOT systems gradually disregarded their observation tasks and eventually became noncompliant with the protocol. On the first day, all participants were trained in accordance with the standard instructions [ 9 ] and performed a real session correctly. On the second and third days, all patients forgot to show their palate area; thus, their observers were not able to adequately see their compliance.…”

Section: Resultsmentioning

confidence: 99%

“…The LINE (Line Corporation) notification application programming interface had been created as part of our previous study [ 9 ]. However, the notification function was disabled at that time for reasons of cost reduction.…”

Section: Methodsmentioning

confidence: 99%

“…Details were added to the standard operating procedures (SOPs) [ 9 ] for the previous version of the TH VOT system with regard to the notification system. The time to take medication was determined and revised, if necessary, by the patients.…”

Section: Methodsmentioning

confidence: 99%

“…The 19 recruited tuberculosis staff, as the observers, familiarized themselves with the system by following the training that was described previously in the pilot study [ 9 ]. In brief, the use of the TH VOT system was explained and demonstrated to the observers.…”

Section: Methodsmentioning

confidence: 99%

“…In order to determine a solution, a qualitative study was conducted, and the observers suggested adding a notification system and an auditor to improve their observation tasks and compliance. The pilot study was also limited by an insufficient sample size and the short duration of users’ experience [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Video-Observed Therapy With a Notification System for Improving the Monitoring of Tuberculosis Treatment in Thailand: Usability Study

Kumwichar¹,

Chongsuvivatwong²,

Prappre³

2022

JMIR Form Res

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Background In Thailand, the health care system has struggled to cope with COVID-19, resulting in directly observed therapy for tuberculosis being de-emphasized. A video-observed therapy (VOT) system, or more specifically, the Thai VOT (TH VOT) system, was developed to replace directly observed therapy. According to the pilot study, the system needed notifications to improve usability and user compliance. The updated version of the TH VOT system thus enabled LINE (Line Corporation) notifications. Objective This study aimed to reassess users’ compliance with and the usability of the updated TH VOT system. Methods This study was conducted in the Hat Yai and Mueang Songkhla districts in Songkhla Province, Southern Thailand, from September 18 to December 1, 2021. The system was used by not only patients with tuberculosis but also tuberculosis staff, who acted as observers in primary health care settings. Some of the observers used the simulated VOT system instead of the actual system due to the lack of participating patients in their jurisdiction. After 30 days of using the system, VOT session records were analyzed to determine the compliance of the patients and observers. The User Experience Questionnaire was administered to reassess the usability of the system and compare the ratings of the participants with the general benchmark scores of the User Experience Questionnaire. The results were summarized to reveal the degree of user compliance and usability in the following three groups: the patients, actual VOT observers, and simulated VOT observers. Results Of the 19 observers, 10 used the actual VOT system, and the remaining 9 used the simulated VOT system; there were also 10 patients with tuberculosis. The patients, actual VOT observers, and simulated VOT observers exhibited about 70%, 65%, and 50% compliance, respectively, in terms of following the standard operating procedures every day. The scores of all groups on all dimensions were well above the average scores. There was no significant difference in any of the dimensional scores among the three groups. Conclusions The updated version of the TH VOT system was deemed usable by both the patients and the health care staff. Compliance with the use of the system was high among the patients but moderate among the observers.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Video-Observed Therapy With a Notification System for Improving the Monitoring of Tuberculosis Treatment in Thailand: Usability Study

Kumwichar¹,

Chongsuvivatwong²,

Prappre³

2022

JMIR Form Res

Self Cite

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Costs of digital adherence technologies for tuberculosis treatment support

Nsengiyumva

Khan²,

Gler³

et al. 2023

Preprint

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Digital adherence technologies (DATs) are increasingly used for tuberculosis (TB) adherence support, but information about their costs remains limited. We used microcosting to estimate health system costs (in 2022 US dollars) of 99DOTS pill sleeves and video-observed treatment (VOT), implemented in demonstration projects during 2018-21. Local cost estimates for standard directly observed treatment (DOT) were also obtained. The estimated per-person costs of 99DOTS for drug-sensitive (DS-) TB were $98, $106, and $174 in Bangladesh (n=719), the Philippines (n=396), and Tanzania (n=976) respectively. The estimated per-person costs of VOT were $1 154, $304, $457, and $661 in Haiti (n=87 DS-TB), Moldova (n=173 DS-TB), Moldova (n=135 drug-resistant [DR]-TB) and the Philippines (n=110 DR-TB) respectively. Health system costs of 99DOTS may be similar to or cheaper than standard DOT. VOT is considerably more expensive; labor cost offsets and/or economies of scale may yield savings relative to standard DOT in some settings.

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Acceptability of video observed treatment vs. directly observed treatment for tuberculosis: a comparative analysis between South and Central India

et al. 2022

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Background Directly Observed Treatment (DOT) is a requirement in the management of Tuberculosis (TB) globally. With the transition from alternate day treatment to daily treatment in India, monitoring treatment adherence through DOT is a logistic challenge. The pervasiveness of mobile phones in India provides a unique opportunity to address this challenge remotely. This study was designed to compare the acceptability of mobile phones for antitubercular treatment (ATT) support in two distinct regions of India. Methodology This was a cross-sectional exploratory study that enrolled 351 patients with TB, of whom 185 were from Bangalore, South India, and 166 from Ujjain, Central India. Trained research assistants administered a pretested questionnaire comprising demographics, phone usage patterns, and acceptability of mobile phone technology to support treatment adherence to TB medicines. Results The mean age of the 351 participants was 32±13.6 years of whom 140 (40%) were women. Of the participants, 259 (74%) were urban, 221 (63%) had >4 years of education. A significantly greater number of participants were newly diagnosed with TB and were in the intensive phase of treatment. Overall, 218 (62%) preferred vDOT over DOT. There was an overall difference in preference between the two sites which is explained by differences in socio-economic variables. Conclusion Mobile phone adherence support is acceptable to patients on Antitubercular treatment ATT with minor variations in design based on demographic and cultural differences. In India, the preference for voice calls over text messages/SMS while designing mHealth interventions cannot be ignored. Of importance is the preference for DOT over vDOT in central India, unlike South India. However, in time, the expanding use of mobile technology supplemented with counseling, could overcome the barriers of privacy and stigma and promote the transition from in-person DOT to vDOT or mobile phone adherence monitoring and support for ATT in India.

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Development of a Video-Observed Therapy System to Improve Monitoring of Tuberculosis Treatment in Thailand: Mixed-Methods Study

Cited by 14 publications

References 14 publications

Video-Observed Therapy With a Notification System for Improving the Monitoring of Tuberculosis Treatment in Thailand: Usability Study

Video-Observed Therapy With a Notification System for Improving the Monitoring of Tuberculosis Treatment in Thailand: Usability Study

Costs of digital adherence technologies for tuberculosis treatment support

Acceptability of video observed treatment vs. directly observed treatment for tuberculosis: a comparative analysis between South and Central India

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