Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA Sungai Buloh Campus, Sungai Buloh, Selangor, 47000, Malaysia.
Department of Pharmaceutical Life Sciences, Faculty of Pharmacy, Universiti Teknologi MARA Puncak Alam Campus, Puncak Alam, Selangor, 42300, Malaysia.
BMC Public Health. 2024 Jan 22;24(1):249. doi: 10.1186/s12889-023-17561-z.
Finding innovative methods to enhance Tuberculosis treatment adherence in Malaysia is imperative, given the rising trend of non-adhere TB patients. Direct Observed Therapy (DOTS) has been used to ensure Tuberculosis (TB) drug compliance worldwide. However, due to its inconvenience, digitalizing this system into a virtual monitoring system via a mobile app can help deliver a more efficient tuberculosis management system. A gamified video-observed therapy is developed that connects three users the patient, supervisor, and administrator, allowing drug monitoring and patient loss to follow up with the patient tracking system. Thus, the objective of this study is to determine the impact of Gamified Real-time Video Observed Therapy (GRVOTS) mobile apps on patient medication adherence rates and motivation.
71 patients from 18 facilities participated in the 8-week single-arm intervention study. GRVOTS mobile apps were installed in their mobile apps, and patients were expected to fulfill tasks such as providing Video Direct Observe Therapy (VDOTS) daily as well as side effect reporting. At 3-time intervals of baseline,1-month, and 2-month intervals, the number of VDOT taken, the Malaysian Medication Adherence Assessment Tool (MyMAAT), and the Intrinsic Motivation Inventory (IMI) questionnaire were collected. One-sample t-test was conducted comparing the VDOT video adherence to the standard rate of 80%. RM ANOVA was used to analyze any significant differences in MyMAAT and IMI scores across three-time intervals.
This study involved 71 numbers of patients from 18 healthcare facilities who showed a significantly higher treatment adherence score of 90.87% than a standard score of 80% with a mean difference of 10.87(95% CI: 7.29,14.46; p < 0.001). The participants' MyMAAT and IMI scores significantly increased over 3-time intervals with the IMI Interest domain showing the highest mean difference 19.76 (95% CI: 16.37, 21.152: p < 0.001).
By utilizing GRVOTS, a mobile application based on gamification and real-time features, we can enhance motivation and medication adherence among TB patients, while also addressing the limitations of physical DOTS.
IRCT20230308057657N1, Registered on (15/03/23).
鉴于马来西亚非依从性结核病患者数量呈上升趋势，寻找创新方法来提高结核病治疗依从性至关重要。直接观察治疗（DOTS）已在全球范围内用于确保结核病（TB）药物的依从性。然而，由于其不便之处，将该系统数字化为移动应用程序中的虚拟监测系统，可以帮助提供更有效的结核病管理系统。开发了一种基于游戏的视频观察治疗方法，将三个用户（患者、监督者和管理员）连接起来，允许药物监测和患者随访与患者跟踪系统一起进行。因此，本研究的目的是确定基于游戏的实时视频观察治疗（GRVOTS）移动应用程序对患者药物依从率和动机的影响。
来自 18 个设施的 71 名患者参加了为期 8 周的单臂干预研究。他们的移动应用程序中安装了 GRVOTS 移动应用程序，预计患者需要完成每日提供视频直接观察治疗（VDOTS）和报告副作用等任务。在基线、1 个月和 2 个月的 3 个时间间隔内，收集了 VDOT 拍摄次数、马来西亚药物依从性评估工具（MyMAAT）和内在动机量表（IMI）问卷。采用单样本 t 检验比较 VDOT 视频依从率与 80%的标准率。采用 RM ANOVA 分析 3 个时间间隔内 MyMAAT 和 IMI 评分的任何显著差异。
这项研究涉及来自 18 个医疗保健设施的 71 名患者，他们的治疗依从性评分显著高于 80%的标准评分，平均差异为 10.87（95%CI：7.29，14.46;p<0.001）。参与者的 MyMAAT 和 IMI 评分在 3 个时间间隔内显著增加，其中 IMI 兴趣领域的平均差异最大为 19.76（95%CI：16.37，21.152;p<0.001）。
通过利用基于游戏化和实时功能的 GRVOTS 移动应用程序，我们可以提高结核病患者的动机和药物依从性，同时解决物理 DOTS 的局限性。
IRCT20230308057657N1，于（15/03/23）注册。
