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Home / The International Journal of Tuberculosis and Lung Disease, Volume 19, Number 9

Feasibility of tuberculosis treatment monitoring by video directly observed therapy: a binational pilot study

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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.

Keywords: DOT; US-Mexico border; cellular phone; drug resistance; mHealth; medication adherence

Document Type: Research Article

Affiliations: 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

Publication date: 01 September 2015

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  • The International Journal of Tuberculosis and Lung Disease (IJTLD) is for clinical research and epidemiological studies on lung health, including articles on TB, TB-HIV and respiratory diseases such as COVID-19, asthma, COPD, child lung health and the hazards of tobacco and air pollution. Individuals and institutes can subscribe to the IJTLD online or in print – simply email us at [email protected] for details.

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