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Evaluation of recorded video-observed therapy for anti-tuberculosis treatment

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BACKGROUND: Asynchronous video directly observed therapy (VDOT) may reduce tuberculosis (TB) program costs and the burden on patients. We compared VDOT performance across three cities in the United States, each of which have TB incidence rates above the national average.

METHODS: Patients aged ≥18 years who are currently receiving directly observed anti-TB treatment were invited to use VDOT for monitoring treatment. Pre- and post-treatment interviews and medical records were used to assess site differences in treatment adherence and patient characteristics and perceptions.

RESULTS: Participants were enrolled in New York City, NY (n = 48), San Diego, CA (n = 52) and San Francisco, CA, USA (n = 49). Overall, the mean age was 41 years (range 18–87); 59% were male; most were Asian (45%) or Hispanic/Latino (30%); and 77% were foreign-born. The median fraction of expected doses observed (FEDO) was 88% (IQR 76–96). At follow-up, 97% thought VDOT was “very or somewhat easy to use” and 95% would recommend VDOT to other TB patients. Age, race/ethnicity, annual income, and country of birth differed by city (P < 0.05), but FEDO and VDOT perceptions did not.

CONCLUSIONS: TB programs in three large US cities observed a high FEDO using VDOT while minimizing staff time and travel. Similar findings across sites support VDOT adoption by other large, urban TB programs.
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Keywords: adherence; mHealth; monitoring

Document Type: Research Article

Affiliations: 1: Division of Epidemiology, School of Medicine, University of California, San Diego, CA 2: Division of Biostatistics and Bioinformatics, School of Medicine, University of California, San Diego, CA 3: Department of Biological Sciences, University of Arkansas, Fayetteville, AR 4: San Diego County Health and Human Services Agency, San Diego, CA 5: Bureau of Tuberculosis Control, New York City Department of Health and Mental Hygiene, Queens, NY 6: San Francisco Department of Public Health, San Francisco, CA 7: Department of Epidemiology, University of Washington School of Public Health, Seattle, WA 8: Qualcomm Institute, Calit2, San Diego Division, University of California, San Diego, CA, USA

Publication date: May 1, 2020

More about this publication?
  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on lung health world-wide.

    To share scientific research of immediate concern as rapidly as possible, The Union is fast-tracking the publication of certain articles from the IJTLD and publishing them on The Union website, prior to their publication in the Journal. Read fast-track articles.

    Certain IJTLD articles are also selected for translation into French, Spanish, Chinese or Russian. These are available on the Union website.

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