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Int J Tuberc Lung Dis. 2016 May;20(5):588-93. doi: 10.5588/ijtld.15.0738.

Enhancing management of tuberculosis treatment with video directly observed therapy in New York City.

Author information

1
New York City Department of Health and Mental Hygiene, Queens, New York, New York, USA.

Abstract

SETTING:

Directly observed therapy (DOT), the standard of care for monitoring patients on treatment for tuberculosis (TB), requires substantial health department resources, and can be inconvenient and disruptive for patients.

OBJECTIVE:

To determine whether video technology for remote observation of patients on anti-tuberculosis treatment (VDOT) is as effective as in-person DOT.

DESIGN:

Eligible TB patients in New York City were prospectively enrolled in VDOT from September 2013 to September 2014. We compared treatment outcomes and worker output for VDOT and in-person DOT.

RESULTS:

Among 390 patients on DOT for the treatment of TB, 61 (16%) were on VDOT and 329 (84%) on in-person DOT. Adherence to scheduled VDOT sessions was 95% (3292/3455) compared to 91% (32 204/35 442) with in-person DOT (>P < 0.01). VDOT enabled a DOT worker to observe a maximum of 25 patients per day, similar to DOT workers who observed patients in clinic (n = 25), but twice that of DOT workers who observed patients in the community (n = 12). Treatment completion with VDOT was similar to that with in-person DOT (96% vs. 97%, P = 0.63). The primary problems encountered during VDOT sessions were interruption of video and audio connectivity.

CONCLUSION:

Implementation of VDOT resulted in successful anti-tuberculosis treatment outcomes while maximizing health department resources.

Comment in

PMID:
27084810
DOI:
10.5588/ijtld.15.0738
[Indexed for MEDLINE]

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