R S Garfein1, K Collins1, F Muñoz1, K Moser2, P Cerecer-Callu3, F Raab4, P Rios5, A Flick5, M L Zúñiga6, J Cuevas-Mota1, K Liang2, G Rangel7, J L Burgos1, T C Rodwell1, K Patrick8. 1. Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, USA. 2. San Diego County Health and Human Services Agency, San Diego, California, USA. 3. Instituto de Servicios de Salud, Tijuana, Baja California, México. 4. Department of Preventive Medicine and Public Health, University of California, San Diego, La Jolla, USA. 5. Qualcomm Institute, University of California, San Diego, La Jolla, USA. 6. School of Social Work, San Diego State University, San Diego, California, USA. 7. Comision de Salud Fronteriza, Sección México-Secretaria de Salud, Tijuana, Baja California, México. 8. Department of Preventive Medicine and Public Health, University of California, San Diego, La Jolla, USA; Qualcomm Institute, University of California, San Diego, La Jolla, USA.
Abstract
BACKGROUND: Although directly observed therapy (DOT) is recommended worldwide for monitoring anti-tuberculosis treatment, transportation and personnel requirements limit its use. OBJECTIVE: To evaluate the feasibility and acceptability of 'video DOT' (VDOT), which allows patients to record and transmit medication ingestion via videos watched remotely by health care providers to document adherence. METHODS: We conducted a single-arm trial among tuberculosis (TB) patients in San Diego, California, USA, (n = 43) and Tijuana, Mexico (n = 9) to represent high- and low-resource settings. Pre-/post-treatment interviews assessed participant characteristics and experiences. Adherence was defined as the proportion of observed doses to expected doses. RESULTS: The mean age was 37 years (range 18-86), 50% were male, and 88% were non-Caucasian. The mean duration of VDOT use was 5.5 months (range 1-11). Adherence was similar in San Diego (93%) and Tijuana (96%). Compared to time on in-person DOT, 92% preferred VDOT, 81% thought VDOT was more confidential, 89% never/rarely had problems recording videos, and 100% would recommend VDOT to others. Seven (13%) participants were returned to in-person DOT and six (12%) additional participants had their phones lost, broken or stolen. CONCLUSIONS: VDOT was feasible and acceptable, with high adherence in both high- and low-resource settings. Efficacy and cost-effectiveness studies are needed.
BACKGROUND: Although directly observed therapy (DOT) is recommended worldwide for monitoring anti-tuberculosis treatment, transportation and personnel requirements limit its use. OBJECTIVE: To evaluate the feasibility and acceptability of 'video DOT' (VDOT), which allows patients to record and transmit medication ingestion via videos watched remotely by health care providers to document adherence. METHODS: We conducted a single-arm trial among tuberculosis (TB) patients in San Diego, California, USA, (n = 43) and Tijuana, Mexico (n = 9) to represent high- and low-resource settings. Pre-/post-treatment interviews assessed participant characteristics and experiences. Adherence was defined as the proportion of observed doses to expected doses. RESULTS: The mean age was 37 years (range 18-86), 50% were male, and 88% were non-Caucasian. The mean duration of VDOT use was 5.5 months (range 1-11). Adherence was similar in San Diego (93%) and Tijuana (96%). Compared to time on in-person DOT, 92% preferred VDOT, 81% thought VDOT was more confidential, 89% never/rarely had problems recording videos, and 100% would recommend VDOT to others. Seven (13%) participants were returned to in-person DOT and six (12%) additional participants had their phones lost, broken or stolen. CONCLUSIONS: VDOT was feasible and acceptable, with high adherence in both high- and low-resource settings. Efficacy and cost-effectiveness studies are needed.
Authors: Jeffrey A Hoffman; Janice R Cunningham; Andrew J Suleh; Aaron Sundsmo; Debra Dekker; Fred Vago; Kelly Munly; Emmy Kageha Igonya; Jonathan Hunt-Glassman Journal: Am J Prev Med Date: 2010-05-26 Impact factor: 5.043
Authors: Garrett R Beeler Asay; Chee Kin Lam; Brock Stewart; Joan M Mangan; Laura Romo; Suzanne M Marks; Sapna Bamrah Morris; Caroline L Gummo; Chris E Keh; Andrew N Hill; Anila Thomas; Michelle Macaraig; Kristen St John; Teresita J Ampie; Christine Chuck; Joseph Burzynski Journal: Am J Public Health Date: 2020-09-17 Impact factor: 9.308
Authors: Payam Nahid; Sundari R Mase; Giovanni Battista Migliori; Giovanni Sotgiu; Graham H Bothamley; Jan L Brozek; Adithya Cattamanchi; J Peter Cegielski; Lisa Chen; Charles L Daley; Tracy L Dalton; Raquel Duarte; Federica Fregonese; C Robert Horsburgh; Faiz Ahmad Khan; Fayez Kheir; Zhiyi Lan; Alfred Lardizabal; Michael Lauzardo; Joan M Mangan; Suzanne M Marks; Lindsay McKenna; Dick Menzies; Carole D Mitnick; Diana M Nilsen; Farah Parvez; Charles A Peloquin; Ann Raftery; H Simon Schaaf; Neha S Shah; Jeffrey R Starke; John W Wilson; Jonathan M Wortham; Terence Chorba; Barbara Seaworth Journal: Am J Respir Crit Care Med Date: 2019-11-15 Impact factor: 21.405
Authors: Margo E Godersky; Jared W Klein; Joseph O Merrill; Kendra L Blalock; Andrew J Saxon; Jeffrey H Samet; Judith I Tsui Journal: J Addict Med Date: 2020 Jul/Aug Impact factor: 3.702