Monitoring Therapy Adherence of Tuberculosis Patients by using Video-Enabled Electronic Devices

Story, Alistair; Garfein, Richard S.; Hayward, Andrew; Rusovich, Valiantsin; Dadu, Andrei; Soltan, Viorel; Oprunenco, Alexandru; Collins, Kelly; Sarin, Rohit; Quraishi, Subhi; Sharma, Mukta; Migliori, Giovanni Battista; Varadarajan, Maithili; Falzon, Dennis

doi:10.3201/eid2203.151620

Cited by 73 publications

(57 citation statements)

References 7 publications

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“…VDOT can overcome the limitations of in-person DOT at the patient and health system levels. For example, VDOT studies have shown that the distance barrier is mostly eliminated [24][25][26], patients have greater autonomy to choose when and where to take their medications [25,27], the costs of travel are minimised [24,28], and providers can support a higher number of patients, thus increasing the health system efficiency [24,29].…”

Section: Introductionmentioning

confidence: 99%

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Video directly observed therapy for supporting and monitoring adherence to tuberculosis treatment in Uganda: a pilot cohort study

et al. 2020

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IntroductionNonadherence to treatment remains an obstacle to tuberculosis (TB) control worldwide. The aim of this study was to evaluate the feasibility of using video directly observed therapy (VDOT) for supporting TB treatment adherence in Uganda.MethodsFrom May to December 2018, we conducted a pilot cohort study at a TB clinic in Kampala City. We enrolled patients aged 18–65 years with ≥3 months remaining of their TB treatment. Participants were trained to use a smartphone app to record videos of medication intake and submit them to a secured system. Trained health workers logged into the system to watch the submitted videos. The primary outcome was adherence measured as the fraction of expected doses observed (FEDO). In a secondary analysis, we examined differences in FEDO by sex, age, phone ownership, duration of follow-up, reasons for missed videos and patients' satisfaction at study exit.ResultsOf 52 patients enrolled, 50 were analysed. 28 (56%) were male, the mean age was 31 years (range 19–50 years) and 35 (70%) owned smartphones. Of the 5150 videos expected, 4231 (82.2%) were received. The median FEDO was 85% (interquartile range 66%–94%) and this significantly differed by follow-up duration. Phone malfunction, uncharged battery and VDOT app malfunctions were the commonest reasons for missed videos. 92% of patients reported being very satisfied with using VDOT.ConclusionVDOT was feasible and acceptable for monitoring and supporting TB treatment. It resulted in high levels of adherence, suggesting that digital technology holds promise in improving patient monitoring in Uganda.

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Section: Introductionmentioning

confidence: 99%

“…Previous studies in high-income [26,27,[30][31][32] and low-income countries [9,33] have reported high adherence and patient satisfaction with VDOT. One study from Kenya showed the promise of digital health interventions for supporting TB treatment success [34]; however, no published studies exist on the use of VDOT in Africa.…”

Section: Introductionmentioning

confidence: 99%

Video directly observed therapy for supporting and monitoring adherence to tuberculosis treatment in Uganda: a pilot cohort study

et al. 2020

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“…Dette kan vaere hensiktsmessig i deler av behandlingsperioden, men ikke nødvendigvis i hele (7). Hjemmebesøk passer ikke alltid inn i pasientens liv (8,24). I vår studie muliggjorde videosamtale observasjon av medikamentinntaket for pasienter som skulle på reise eller ville unngå oppmerksomhet fra naboer.…”

Section: Datainnsamlingunclassified

Bruk av videosamtale i behandling av tuberkulose-sykdom i Nord-Norge

Bendiksen¹,

Ovesen²,

Asfeldt³

et al. 2020

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“…35 In the interim, use of video directly observed therapy could be considered to decrease costs. 36 To increase both acceptance and completion of testing and treatment, other interventions that can be considered include incentives and enablers, culturally specific education or counselling, and increased access through expanded clinic hours. 37,38 While not currently used in the USA, 3 months of daily isoniazid and rifampicin is another short-course regimen that has been used successfully in other countries.…”

Section: Opportunities For Testing and Treatment Of Latent Tuberculosmentioning

confidence: 99%

Latent tuberculosis infection: the final frontier of tuberculosis elimination in the USA

LoBue

Mermin

2017

The Lancet Infectious Diseases

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Since 1989, the USA has been pursuing the goal of tuberculosis elimination. After substantial progress during the past two decades, the rate of tuberculosis cases in the USA each year has now levelled off and remains well above the elimination threshold. Both epidemiological data and modelling underline the necessity of addressing latent tuberculosis infection if further progress is to be made in eliminating the disease. In this Personal View we explore next steps towards elimination. Given the estimated prevalence of latent tuberculosis infection, compared with the limited testing and treatment that currently occur, a major new effort is required. This effort should consist of a surveillance system or registry to monitor progress, scale-up of targeted testing for latent tuberculosis infection in at-risk populations, scale-up of short-course treatment regimens, engagement of affected communities and medical providers who serve those communities, and increased public health staffing for implementation and oversight. Such an effort would benefit greatly from the development of new tools, such as tests that better indicate reactivation risk, and even shorter latent tuberculosis infection treatment regimens than currently exist.

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Monitoring Therapy Adherence of Tuberculosis Patients by using Video-Enabled Electronic Devices

Cited by 73 publications

References 7 publications

Video directly observed therapy for supporting and monitoring adherence to tuberculosis treatment in Uganda: a pilot cohort study

Video directly observed therapy for supporting and monitoring adherence to tuberculosis treatment in Uganda: a pilot cohort study

Bruk av videosamtale i behandling av tuberkulose-sykdom i Nord-Norge

Latent tuberculosis infection: the final frontier of tuberculosis elimination in the USA

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