Woolcock Institute of Medical Research, Glebe, NSW 2037, Australia.
National Lung Hospital, Ba Dinh, Hanoi, Vietnam; Hanoi Medical University, Hanoi, Vietnam.
Int J Infect Dis. 2017 Dec;65:85-89. doi: 10.1016/j.ijid.2017.09.029. Epub 2017 Oct 10.
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.
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.
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.
VDOT was feasible and resulted in high rates of treatment adherence in a resource-limited setting.
在资源有限的环境中，确保患者完全遵循其治疗方案是结核病控制规划面临的主要挑战。本研究在越南河内的 3 个门诊结核病诊所进行。我们旨在评估使用异步视频直接观察治疗（VDOT）支持经细菌学确诊的肺结核患者治疗依从性的可行性。
在这项队列研究中，连续邀请经细菌学确诊患有肺结核的成年患者参加 VDOT 计划。患者接受使用智能手机记录自己服用结核病治疗药物的培训。视频被上传到在线服务器，研究人员每天至少审查两个月。根据每月的药丸计数来评估依从性。
2016 年 11 月至 2017 年 1 月期间，78 名符合条件的参与者中有 40 名（51.3%）同意开始 VDOT。在参与的患者中，27 名（71.1%）患者服用了所有规定剂量的药物。正确记录并上传的剂量中位数为 88.4%（四分位距 75.8%-93.7%）。尽管参与者最初面临一些技术困难，但他们对 VDOT 界面的评价很高。
VDOT 在资源有限的环境中是可行的，并且可以实现高治疗依从率。
