研究视频直接观察疗法(VDOT)在结核病(TB)治疗中的综合疗效:佛罗里达州的全州分析

IF 1.9 Q3 INFECTIOUS DISEASES
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引用次数: 0

摘要

目标确定将 VDOT 纳入结核病治疗是否显示出非劣于直接观察,以及在 Covid-19 开始后,佛罗里达州的 VDOT 利用率是否有所提高。方法对佛罗里达州卫生部记录的 2018 年 1 月至 2018 年 12 月和 2020 年 1 月至 2021 年 12 月期间开始接受结核病治疗的所有患者进行全州范围的项目审查。使用 VDOT 的患者治疗完成率为 97.2%,而仅使用 DOT 的患者治疗完成率为 92.3%(p=<.001)。仅使用 DOT 的患者平均治疗时间为 220.5 天,而使用 VDOT 的患者平均治疗时间为 211.1 天(p=.027)。在 Covid-19 期间,整个佛罗里达州的 VDOT 使用率增加了 176.35%。结论这是第一项评估将 VDOT 纳入结核病治疗的疗效的全州范围内最大规模的研究,发现在完成治疗和治疗持续时间方面有统计学意义的显著改善。尽管自 Covid-19 开始以来,VDOT 的使用率有所提高,但我们怀疑可能有多种障碍阻碍了进一步的整合。在监测结核病治疗方面,VDOT 应被推荐为一种具有成本效益且不劣于 DOT 的替代方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Investigating the efficacy of integrating video-directly observed therapy (VDOT) in the treatment of tuberculosis (TB): A statewide analysis from Florida

Objectives

To determine if integrating VDOT into TB therapy demonstrated non-inferiority to direct observation, and if VDOT utilization increased across Florida after the onset of Covid-19.

Methods

A statewide programmatic review was conducted of all patients in Florida who initiated tuberculosis treatment between January 2018 – December 2018 and January 2020 – December 2021, as documented by the Florida Department of Health.

Results

1361 patients received treatment within the analysis timeframe. Therapy completion was 97.2% in those utilizing VDOT compared to 92.3% utilizing only DOT (p=<.001). Average duration of therapy was 220.5 days in the DOT-only cohort compared to 211.1 days with VDOT integration (p=.027). A 176.35% increase in VDOT utilization was seen across Florida during Covid-19.

Conclusions

This is the first and largest state-wide study evaluating the efficacy of integrating VDOT into TB therapy, finding statistically significant improvements in completion and duration of therapy. Despite increased VDOT utilization since the onset of Covid-19, we suspect that multiple barriers may be hindering further integration. VDOT should be recommended as a cost effective, non-inferior alternative to DOT in monitoring the treatment of tuberculosis.

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来源期刊
Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Medicine-Pulmonary and Respiratory Medicine
CiteScore
4.00
自引率
5.00%
发文量
44
审稿时长
30 weeks
期刊介绍: Journal of Clinical Tuberculosis and Mycobacterial Diseases aims to provide a forum for clinically relevant articles on all aspects of tuberculosis and other mycobacterial infections, including (but not limited to) epidemiology, clinical investigation, transmission, diagnosis, treatment, drug-resistance and public policy, and encourages the submission of clinical studies, thematic reviews and case reports. Journal of Clinical Tuberculosis and Mycobacterial Diseases is an Open Access publication.
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