Feasibility and acceptability pilot of video-based direct observed treatment (vDOT) for supporting antitubercular treatment in South India: a cohort study

Rodrigues, Rashmi; Varghese, Suman Sarah; Mahrous, Mohammed; Kumar, Anil; Ahmed, Muhammed

doi:10.1136/bmjopen-2022-065878

Cited by 3 publications

(1 citation statement)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Notably, video-DOT for TB treatment is accepted by the WHO and the U.S. Centers for Disease Control and Prevention as a treatment delivery strategy because it achieves treatment outcomes that are at least as effective as conventional DOT, though these effectiveness data come mostly from highincome settings [33,34]. Nonetheless, growing evidence from high TB-burden, resource-limited settings like India also support the acceptability and feasibility of video-DOT [35,36]. Finally, rollout of two newly recommended shorter, four-month regimens for drug-susceptible pulmonary TB-the SHINE regimen for people <16 years old with non-severe disease and the rifapentine-moxifloxacin regimen for people �12 years old with any disease severity [37][38][39]may decrease treatment fatigue.…”

Section: Plos Global Public Healthmentioning

confidence: 99%

Identifying adolescents at risk for suboptimal adherence to tuberculosis treatment: A prospective cohort study

Chiang,

Tanzer,

Starke

et al. 2024

PLOS Glob Public Health

View full text Add to dashboard Cite

Adolescents account for an estimated 800,000 incident tuberculosis (TB) cases annually and are at risk for suboptimal adherence to TB treatment. Most studies of adolescent TB treatment adherence have used surveillance data with limited psychosocial information. This prospective cohort study aimed to identify risk factors for suboptimal adherence to rifampicin-susceptible TB treatment among adolescents (10–19 years old) in Lima, Peru. We collected psychosocial data using self-administered surveys and clinical data via medical record abstraction. Applying k-means cluster analysis, we grouped participants by psychosocial characteristics hypothesized to impact adherence. Then, we conducted mixed effects regression to compare suboptimal adherence–defined as <90% (missing >10% of doses)–between clusters. Treatment setting (facility vs. home) and drug formulation (single drug vs. fixed dose combination) were interaction terms. Of 249 participants, 90 (36.1%) were female. Median age was 17 (IQR: 15, 16.6) years. We identified three clusters–A, B, and C–of participants based on psychosocial characteristics. Cluster C had the lowest support from caregivers, other family members, and friends; had the weakest motivation to complete TB treatment; were least likely to live with their mothers; and had experienced the most childhood adversity. Among the 118 (47.4%) participants who received facility-based treatment with single drug formulations, adherence did not differ between Clusters A and B, but Cluster C had six-fold odds of suboptimal adherence compared to Cluster A. In Clusters B and C, adherence worsened over time, but only in Cluster C did mean adherence fall below 90% within six months. Our findings have implications for the care of adolescents with TB. When caring for adolescents with low social support and other risk factors, clinicians should take extra measures to reinforce adherence, such as identifying a community health worker or peer to provide treatment support. Implementing newly recommended shorter regimens also may facilitate adherence.

show abstract

Section: Plos Global Public Healthmentioning

confidence: 99%

Identifying adolescents at risk for suboptimal adherence to tuberculosis treatment: A prospective cohort study

Chiang,

Tanzer,

Starke

et al. 2024

PLOS Glob Public Health

View full text Add to dashboard Cite

show abstract

Mapping Respiratory Health Digital Interventions in South and Southeast Asia: A Scoping Review

Evans,

Abdullah

et al. 2024

Preprint

View full text Add to dashboard Cite

Background: Digital health has progressed rapidly due to the advances in technology and the promises of improved health and personal health empowerment. Concurrently, the burden of respiratory disease is increasing, particularly in Asia, where mortality rates are higher, and public awareness and government engagement are lower than in other regions of the world. Leveraging digital health interventions to manage and mitigate respiratory disease presents itself as a potentially effective approach. This study aims to undertake a scoping review to map respiratory digital health interventions in South and Southeast Asia, identify existing technologies, opportunities, and gaps, and put forward pertinent recommendations from the insights gained. Methods: This study used a scoping review methodology as outlined by Arksey and O’Malley and the Joanna Briggs Institute. Medline, Embase, CINAHL, PsycINFO, Cochrane Library, Web of Science, PakMediNet and MyMedR databases were searched along with key websites grey literature databases. Results: This scoping review has extracted and analysed data from 87 studies conducted in 14 South and Southeast Asian countries. Results were mapped to the WHO classification of digital health interventions categories to better understand their use. Digital health interventions are primarily being used for communication with patientes and between patients and providers. Moreover, interventions targeting tuberculosis were the most numerous. Many ‘old’ interventions, such as SMS, are still being used but updated. Artificial intelligence and machine learning are also widely used in the region at a small scale. There was a high prevalence of pilot interventions compared to mature ones. Conclusions: This scoping review collates and synthesises information and knowledge in the current state of digital health interventions, showing that there is a need to evaluate whether a pilot project is needed before starting, there is a need to report on interventions systematically to aid evaluation and lessons learnt, and that artificial intelligence and machine learning interventions are promising but should adhere to best ethical and equity practices.

show abstract

Effectiveness of Video-Observed Therapy in Tuberculosis Management: A Systematic Review

Sundaram,

Ahmad Zaki,

Shankar

et al. 2024

Cureus

View full text Add to dashboard Cite

This systematic review aimed to assess the association between video-observed therapy (VOT) and treatment adherence among TB patients and the benefits and limitations of this treatment modality. The systematic review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow guideline. Multiple databases including Cochrane, Lilacs, PubMed, Scopus, Lancet, Google Scholar, Science Direct, Directory of Open Access Journal (DOAJ), and BMC were employed to identify relevant articles published between 2012 and 2024. All data were extracted using a standardized data extraction form and both narrative and quantitative approaches were used to present the review outcomes and available evidence. Twenty-nine articles were included in the final analysis, with most using a prospective cohort (n = 10) research design. Treatment adherence rates were relatively higher in TB patients managed using VOT relative to those subjected to direct-observed therapies (DOTs). Likewise, using the VOT approach in most interventional studies lacking a control group depicted higher treatment adherence rates post-intervention. Although asynchronous VOT was used in most studies compared to the synchronous approach, the treatment adherence level was not significantly different between the two methods of VOT delivery. The predominant benefits of VOT include time-saving, cost-effectiveness, flexibility, and fewer self-reported side effects, whereas the main limitation was the privacy of patients’ data and information. Video-directly observed therapy (VDOT) is a promising approach for TB treatment with the capacity to improve adherence to medication regimes and reduce the cost of treatment, stigmatization, and burden on healthcare providers.

show abstract

Feasibility and acceptability pilot of video-based direct observed treatment (vDOT) for supporting antitubercular treatment in South India: a cohort study

Cited by 3 publications

References 19 publications

Identifying adolescents at risk for suboptimal adherence to tuberculosis treatment: A prospective cohort study

Identifying adolescents at risk for suboptimal adherence to tuberculosis treatment: A prospective cohort study

Mapping Respiratory Health Digital Interventions in South and Southeast Asia: A Scoping Review

Effectiveness of Video-Observed Therapy in Tuberculosis Management: A Systematic Review

Contact Info

Product

Resources

About