Telehealth monitoring of patients receiving tuberculosis treatments is more effective and cheaper than in-person monitoring, according to a study published in Emerging Infectious Diseases.
Researchers with the University of California San Diego School of Medicine recently analyzed the effectiveness of two separate therapy methods that ensure tuberculosis patients take their required medications to treat the disease.
According to the study, there was a slight increase in tuberculosis incidence rates in 2015 after it had been steadily declining for 20 years. The state of California has seen the most cases of tuberculosis in the country and the third-highest incidence rate.
Although tuberculosis is treatable, poor medication adherence leads to the ongoing transmission of the disease and the progression and development of drug-resistant strains. To combat this, healthcare organizations have used directly observed therapy (DOT)—which requires healthcare workers or designees to watch patients take their medications—as a treatment method.
However, the researchers argued that DOT’s effectiveness varies and is associated with high costs for patients. They also noted that other healthcare agencies are using videoconferencing technology, like videophones, computers and smartphones, to overcome some associated risks of DOT.
Video directly observed therapy (VDOT) requires patients to record themselves taking their treatments and send the videos to a healthcare worker. Each dose is recorded, timestamped and uploaded to a secure network.
To compare the two methods, researchers monitored the tuberculosis treatments in five urban and rural health districts in California. They compared the adherence rates between 274 patients using VDOT and 159 patients using DOT. The results showed patients using VDOT had a higher medication adherence than those using DOT.
According to the study, the median fraction of expected doses observed (FEDO) among VDOT participants was 93 percent, while it was was 66.4 percent among DOT participants. FEDO equals the “number of observed doses divided by the sum of observed doses, missed doses and self-administered doses,” the study states.
The study revealed that 96 percent of VDOT participants would recommend the therapy to others. It is also a cheaper alternative to DOT.
“The estimated cost for monitoring a six-month treatment regimen using VDOT varied by site (range $3,031 to $3,911) and was 6 percent to 46 percent cheaper than community-based DOT (range $3,212 to $5,788) across sites. Reduced personnel costs drove savings, which offset smartphone-related costs,” the study said.
Based on the results, the authors concluded VDOT was a more feasible, acceptable and effective treatment method than DOT.
“VDOT performed similarly in urban and rural health departments, with high observation rates and positive patient perceptions across sites,” the study concluded. “Although some participants returned to DOT, most were effectively monitored to completion by using VDOT.”
Danielle covers Clinical Innovation & Technology as a senior news writer for TriMed Media. Previously, she worked as a news reporter in northeast Missouri and earned a journalism degree from the University of Illinois at Urbana-Champaign. She's also a huge fan of the Chicago Cubs, Bears and Bulls.