title: Feasibility of tuberculosis treatment monitoring by video directly observed therapy: a binational pilot study.
abstract: BACKGROUND
  Although directly observed therapy (DOT) is recommended worldwide for monitoring anti-tuberculosis treatment, transportation and personnel requirements limit its use.
  
  
  OBJECTIVE
  To evaluate the feasibility and acceptability of 'video DOT' (VDOT), which allows patients to record and transmit medication ingestion via videos watched remotely by health care providers to document adherence.
  
  
  METHODS
  We conducted a single-arm trial among tuberculosis (TB) patients in San Diego, California, USA, (n = 43) and Tijuana, Mexico (n = 9) to represent high- and low-resource settings. Pre-/post-treatment interviews assessed participant characteristics and experiences. Adherence was defined as the proportion of observed doses to expected doses.
  
  
  RESULTS
  The mean age was 37 years (range 18-86), 50% were male, and 88% were non-Caucasian. The mean duration of VDOT use was 5.5 months (range 1-11). Adherence was similar in San Diego (93%) and Tijuana (96%). Compared to time on in-person DOT, 92% preferred VDOT, 81% thought VDOT was more confidential, 89% never/rarely had problems recording videos, and 100% would recommend VDOT to others. Seven (13%) participants were returned to in-person DOT and six (12%) additional participants had their phones lost, broken or stolen.
  
  
  CONCLUSIONS
  VDOT was feasible and acceptable, with high adherence in both high- and low-resource settings. Efficacy and cost-effectiveness studies are needed.
authors.affiliation: Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, USA.
authors.forename: R S
authors.initials: RS
authors.lastname: Garfein
authors.affiliation: Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, USA.
authors.forename: K
authors.initials: K
authors.lastname: Collins
authors.affiliation: Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, USA.
authors.forename: F
authors.initials: F
authors.lastname: Muñoz
authors.affiliation: San Diego County Health and Human Services Agency, San Diego, California, USA.
authors.forename: K
authors.initials: K
authors.lastname: Moser
authors.affiliation: Instituto de Servicios de Salud, Tijuana, Baja California, México.
authors.forename: P
authors.initials: P
authors.lastname: Cerecer-Callu
authors.affiliation: Department of Preventive Medicine and Public Health, University of California, San Diego, La Jolla, USA.
authors.forename: F
authors.initials: F
authors.lastname: Raab
authors.affiliation: Qualcomm Institute, University of California, San Diego, La Jolla, USA.
authors.forename: P
authors.initials: P
authors.lastname: Rios
authors.affiliation: Qualcomm Institute, University of California, San Diego, La Jolla, USA.
authors.forename: A
authors.initials: A
authors.lastname: Flick
authors.affiliation: School of Social Work, San Diego State University, San Diego, California, USA.
authors.forename: M L
authors.initials: ML
authors.lastname: Zúñiga
authors.affiliation: Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, USA.
authors.forename: J
authors.initials: J
authors.lastname: Cuevas-Mota
authors.affiliation: San Diego County Health and Human Services Agency, San Diego, California, USA.
authors.forename: K
authors.initials: K
authors.lastname: Liang
authors.affiliation: Comision de Salud Fronteriza, Sección México-Secretaria de Salud, Tijuana, Baja California, México.
authors.forename: G
authors.initials: G
authors.lastname: Rangel
authors.affiliation: Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, USA.
authors.forename: J L
authors.initials: JL
authors.lastname: Burgos
authors.affiliation: Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, USA.
authors.forename: T C
authors.initials: TC
authors.lastname: Rodwell
authors.affiliation: Department of Preventive Medicine and Public Health, University of California, San Diego, La Jolla, USA; Qualcomm Institute, University of California, San Diego, La Jolla, USA.
authors.forename: K
authors.initials: K
authors.lastname: Patrick
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000627:therapeutic use*; D002140:California; D040421:Cell Phone; D003362:Cost-Benefit Analysis; D023801:Directly Observed Therapy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008800:Mexico; D008875:Middle Aged; D010865:Pilot Projects; D017216:Telemedicine / Q000379:methods*; D014376:Tuberculosis / Q000188:drug therapy*; D014741:Video Recording; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents