Programmatic Adoption and Implementation of Video-Observed Therapy in Minnesota: Prospective Observational Cohort Study.
Programmatic Adoption and Implementation of Video-Observed Therapy in Minnesota: Prospective Observational Cohort Study.
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DOI：
10.2196/38247
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发表时间：
2022-08-05
影响因子：
2.2
通讯作者：
Shah, Maunank
中科院分区：
文献类型：
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作者：
Bachina, Preetham;Lippincott, Christopher Kirk;Perry, Allison;Munk, Elizabeth;Maltas, Gina;Bohr, Rebecca;Rock, Robert Bryan;Shah, Maunank
关键词：
在美国，面对面直接观察治疗（DOT）是结核病治疗依从性监测的标准护理，视频DOT （vDOT）的使用越来越多。在明尼阿波利斯，vDOT于2019年投入使用。在本文中，我们旨在评估vDOT在项目设置中的使用和有效性，包括比较接受vDOT和亲自DOT的患者的验证依从性。我们还试图了解COVID-19对结核病治疗依从性和技术采用的影响。我们提取了2019年9月至2021年6月期间在明尼苏达州明尼阿波利斯接受结核病治疗的个体的常规收集数据。我们的主要结局是评估vDOT的使用和治疗依从性，定义为通过观察（亲自与视频dot）验证的处方剂量（每周7天）的比例，并比较covid -19前（2020年3月之前）和covid -19后（2020年3月之后）期间接受治疗的个体；在COVID-19后时期，我们评估了COVID-19早期（2020年3月至8月）和COVID-19期间（2020年8月之后）。49例结核病患者（平均年龄41岁，SD 19; n= 27,55%为女性，n= 47,96%为非美国出生）中，18例（36.7%）在covid -19后期间接受了治疗。总体而言，与现场DOT（平均54.5%,SD 10.9； P=.001）相比，使用vDOT（平均81%，SD 17.4）时验证的依从性（观察剂量的比例）显着更高。采用vDOT的结核病患者从covid -19前期的35%（11/31）显著增加到covid -19后的67% (12/18)（P= 0.04）。因此，在整个研究期间，所有临床结核病患者的总体验证（即观察到的）依从性均有所改善（在covid -19之前、早期和内部分别为56%、67%和79%，P= 0.001）。COVID-19期间后，vDOT的使用增加，在验证处方治疗的摄入方面比现场DOT更有效，并且尽管COVID-19大流行开始，但导致临床验证依从性总体增加。
In-person directly observed therapy (DOT) is standard of care for tuberculosis (TB) treatment adherence monitoring in the US, with increasing use of video-DOT (vDOT). In Minneapolis, vDOT became available in 2019. In this paper, we aimed to evaluate the use and effectiveness of vDOT in a program setting, including comparison of verified adherence among those receiving vDOT and in-person DOT. We also sought to understand the impact of COVID-19 on TB treatment adherence and technology adoption. We abstracted routinely collected data on individuals receiving therapy for TB in Minneapolis, MN, between September 2019 and June 2021. Our primary outcomes were to assess vDOT use and treatment adherence, defined as the proportion of prescribed doses (7 days per week) verified by observation (in person versus video-DOT), and to compare individuals receiving therapy in the pre–COVID-19 (before March 2020), and post–COVID-19 (after March 2020) periods; within the post–COVID-19 period, we evaluated early COVID-19 (March-August 2020), and intra–COVID-19 (after August 2020) periods. Among 49 patients with TB (mean age 41, SD 19; n=27, 55% female and n=47, 96% non–US born), 18 (36.7%) received treatment during the post–COVID-19 period. Overall, verified adherence (proportion of observed doses) was significantly higher when using vDOT (mean 81%, SD 17.4) compared to in-person DOT (mean 54.5%, SD 10.9; P=.001). The adoption of vDOT increased significantly from 35% (11/31) of patients with TB in the pre–COVID-19 period to 67% (12/18) in the post–COVID-19 period (P=.04). Consequently, overall verified (ie, observed) adherence among all patients with TB in the clinic improved across the study periods (56%, 67%, and 79%, P=.001 for the pre–, early, and intra–COVID-19 periods, respectively). vDOT use increased after the COVID-19 period, was more effective than in-person DOT at verifying ingestion of prescribed treatment, and led to overall increased verified adherence in the clinic despite the onset of the COVID-19 pandemic.
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DOI：
10.5588/ijtld.21.0170
发表时间：
2021-08-01
期刊：
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease
影响因子：
--
作者：
Perry A;Chitnis A;Chin A;Hoffmann C;Chang L;Robinson M;Maltas G;Munk E;Shah M
通讯作者：
Shah M
影响因子：
13.8
作者：
Burzynski J;Mangan JM;Lam CK;Macaraig M;Salerno MM;deCastro BR;Goswami ND;Lin CY;Schluger NW;Vernon A;eDOT Study Team
通讯作者：
eDOT Study Team
DOI：
10.5588/ijtld.19.0456
发表时间：
2020-05-01
影响因子：
4
作者：
Garfein, R. S.;Liu, L.;Rios, P.
通讯作者：
Rios, P.
影响因子：
168.9
作者：
Story, Alistair;Aldridge, Robert W.;Hayward, Andrew C.
通讯作者：
Hayward, Andrew C.
影响因子：
11.8
作者：
Garfein, Richard S.;Liu, Lin;Raab, Fredric
通讯作者：
Raab, Fredric