Tuberculosis treatment monitoring by video directly observed therapy in 5 health districts, California, USA

Richard S. Garfein, Lin Liu, Jazmine Cuevas-Mota, Kelly Collins, Fatima Muñoz, Donald G. Catanzaro, Kathleen Moser, Julie Higashi, Teeb Al-Samarrai, Paula Kriner, Julie Vaishampayan, Javier Cepeda, Michelle A. Bulterys, Natasha K. Martin, Phillip Rios, Fredric Raab

Research output: Contribution to journalArticlepeer-review

Abstract

We assessed video directly observed therapy (VDOT) for monitoring tuberculosis treatment in 5 health districts in California, USA, to compare adherence between 174 patients using VDOT and 159 patients using in-person directly observed therapy (DOT). Multivariable linear regression analyses identified participant-reported sociodemographics, risk behaviors, and treatment experience associated with adherence. Median participant age was 44 (range 18–87) years; 61% of participants were male. Median fraction of expected doses observed (FEDO) among VDOT participants was higher (93.0% [interquartile range (IQR) 83.4%–97.1%]) than among patients receiving DOT (66.4% [IQR 55.1%– 89.3%]). Most participants (96%) would recommend VDOT to others; 90% preferred VDOT over DOT. Lower FEDO was independently associated with US or Mexico birth, shorter VDOT duration, finding VDOT difficult, frequently taking medications while away from home, and having video-recording problems (p<0.05). VDOT cost 32% (range 6%–46%) less than DOT. VDOT was feasible, acceptable, and achieved high adherence at lower cost than DOT.

Original languageEnglish (US)
Pages (from-to)1806-1815
Number of pages10
JournalEmerging infectious diseases
Volume24
Issue number10
DOIs
StatePublished - Oct 2018
Externally publishedYes

ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases

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