Thu Anh Nguyen1, Minh Tam Pham2, Thi Loi Nguyen3, Viet Nhung Nguyen4, Duc Cuong Pham5, Binh Hoa Nguyen6, Greg James Fox7. 1. Woolcock Institute of Medical Research, Glebe, NSW 2037, Australia. Electronic address: thuanh.nguyen@sydney.edu.au. 2. Woolcock Institute of Medical Research, Glebe, NSW 2037, Australia. Electronic address: tam.phamminh@sydney.edu.au. 3. Woolcock Institute of Medical Research, Glebe, NSW 2037, Australia. Electronic address: loi.nguyenthi@woolcock.org.au. 4. National Lung Hospital, Ba Dinh, Hanoi, Vietnam; Hanoi Medical University, Hanoi, Vietnam. Electronic address: vietnhung@yahoo.com. 5. Woolcock Institute of Medical Research, Glebe, NSW 2037, Australia. Electronic address: cuong.phamduc@sydney.edu.au. 6. Hanoi Medical University, Hanoi, Vietnam; Centre for Operational Research, International Union Against Tuberculosis and Lung Disease, Paris, France. Electronic address: nguyenbinhhoatb@yahoo.com. 7. Woolcock Institute of Medical Research, Glebe, NSW 2037, Australia; Sydney Medical School, University of Sydney, NSW 2006, Australia. Electronic address: greg.fox@sydney.edu.au.
Abstract
BACKGROUND: Ensuring patients fully adhere to their treatment is a major challenge for TB control programmes in resource-limited settings. This study was conducted three outpatient tuberculosis clinics in Hanoi, Vietnam. We aimed to evaluate the feasibility of using asynchronous Video Directly Observed Therapy (VDOT) to support treatment adherence among patients with bacteriologically confirmed pulmonary tuberculosis. METHODS: In this cohort study, consecutive adult patients with bacteriologically confirmed pulmonary TB were invited to enroll in a programme of VDOT. Patients were trained to use a smartphone to record themselves taking treatment for TB. Videos were uploaded to an online server and reviewed daily by study staff for at least two months. Adherence was evaluated based upon monthly pill count. RESULTS: Between November 2016 and January 2017, 40 of 78 eligible participants (51.3%) agreed to commence VDOT. Among participating patients, 27 (71.1%) of patients took all required doses. A median of 88.4% (interquartile range 75.8%-93.7%) of doses were correctly recorded and uploaded. Participants rated the VDOT interface highly, despite facing some initial technical difficulties. CONCLUSION: VDOT was feasible and resulted in high rates of treatment adherence in a resource-limited setting.
BACKGROUND: Ensuring patients fully adhere to their treatment is a major challenge for TB control programmes in resource-limited settings. This study was conducted three outpatienttuberculosis clinics in Hanoi, Vietnam. We aimed to evaluate the feasibility of using asynchronous Video Directly Observed Therapy (VDOT) to support treatment adherence among patients with bacteriologically confirmed pulmonary tuberculosis. METHODS: In this cohort study, consecutive adult patients with bacteriologically confirmed pulmonary TB were invited to enroll in a programme of VDOT. Patients were trained to use a smartphone to record themselves taking treatment for TB. Videos were uploaded to an online server and reviewed daily by study staff for at least two months. Adherence was evaluated based upon monthly pill count. RESULTS: Between November 2016 and January 2017, 40 of 78 eligible participants (51.3%) agreed to commence VDOT. Among participating patients, 27 (71.1%) of patients took all required doses. A median of 88.4% (interquartile range 75.8%-93.7%) of doses were correctly recorded and uploaded. Participants rated the VDOT interface highly, despite facing some initial technical difficulties. CONCLUSION: VDOT was feasible and resulted in high rates of treatment adherence in a resource-limited setting.
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