Contribution of Video Directly Observed Therapy (VDOT) to Tuberculosis Treatment in Brazil.

Abstract

Directly Observed Treatment (DOT) involves the administration of medication and in-person monitoring by a healthcare team alongside the patient to improve adherence to tuberculosis (TB) treatment. Implementing DOT requires healthcare professionals, transportation, time dedication, and presence at the patient's residence. Meeting all these conditions is not always possible to address the high demand of TB patients who would benefit from this supervision. Video Directly Observed Therapy (VDOT) is a telecare platform created to remotely oversee the treatment of TB patients, allowing them to daily record medication intake, as prescribed, using their cell phones, clarify doubts, and facilitate communication with the healthcare team providing support. The medication intake data is recorded and accessible to healthcare professionals who monitor adherence remotely. The investigation reported in this work was conducted in Ribeirão Preto, Brazil, from May 5, 2020, to May 4, 2023, across five healthcare units. During the study period, 26,253 medication intake videos were collected and sent from 259 patients. Regarding the outcome reported by supervisors, only 9.7% of patients had their VDOT follow-up terminated due to abandonment, while the Cure/Treatment completion rate was 57.5%. Regarding adherence to the established treatment period for TB and for each patient in their specific situation, 67% of patients completed more than 66% of the treatment. The data suggested good acceptance of the system by both patients and healthcare professionals. VDOT may be a promising tool that complements TB DOT, extending its reach to improve adherence and reduce abandonment rates.