Mobile Direct Observation Treatment for Tuberculosis Patients A Technical Feasibility Pilot Using Mobile Phones in Nairobi, Kenya
Mobile Direct Observation Treatment for Tuberculosis Patients A Technical Feasibility Pilot Using Mobile Phones in Nairobi, Kenya
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DOI：
10.1016/j.amepre.2010.02.018
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发表时间：
2010-07-01
影响因子：
5.5
通讯作者：
Hunt-Glassman, Jonathan
中科院分区：
文献类型：
--
作者：
Hoffman, Jeffrey A.;Cunningham, Janice R.;Hunt-Glassman, Jonathan
背景：移动电话普及率的增长为包括结核病(TB)或艾滋病毒/艾滋病在内的服务不足的高危人群创造了新的机会，并改善了他们的护理。目的：本文总结了一项旨在为结核病患者提供远程移动直接观察治疗(MDOT)的概念验证试点。MDOT模式通过使用手机视频采集和传输，将诊所和社区DOT结合起来，减轻了患者和卫生专业人员的出行负担。方法：从肯尼亚内罗毕的姆巴加蒂地区医院招募3名卫生专业人员和13名患者及其治疗支持者。治疗支持者被要求每天拍摄患者吞下他们的药物的视频。患者提交了视频供卫生专业人员审查，并被要求观看激励和教育结核病文本(短信)和视频健康信息。调查在摄入量、15天和30天进行。数据收集于2008年，并于2009年进行分析。结果：3名医务人员和11名患者均完成了试验。所有人都认为MDOT是一个可行的方案，8名患者通过走访社区卫生工作者倾向于MDOT而不是临床DOT或DOT。患者和卫生专业人员似乎都被彼此沟通的能力所赋予了权力，并似乎都能接受远程MDOT和移动卫生信息。应该进行进一步的研究，以评估MDOT(1)是否可以改善服药依从性，(2)是否具有成本效益，以及(3)是否可以用于改善艾滋病等其他疾病的治疗依从性。(Am J Prey Med 2010；39(1)：78-80)(C)2010年美国预防医学杂志
Background: Growth in mobile phone penetration has created new opportunities to reach and improve care to underserved, at-risk populations including those with tuberculosis (TB) or HIV/AIDS.Purpose: This paper summarizes a proof-of-concept pilot designed to provide remote Mobile Direct Observation of Treatment (MDOT) for TB patients. The MDOT model combines Clinic with Community DOT through the use of mobile phone video capture and transmission, alleviating the travel burden for patients and health professionals.Methods: Three healthcare professionals along with 13 patients and their treatment supporters were recruited from the Mbagathi District Hospital in Nairobi, Kenya. Treatment supporters were asked to take daily videos of the patient swallowing their medications. Patients submitted the videos for review by the health professionals and were asked to view motivational and educational TB text (SMS) and video health messages. Surveys were conducted at intake, 15 days, and 30 days. Data were collected in 2008 and analyzed in 2009.Results: All three health professionals and 11 patients completed the trial. All agreed that MDOT was a viable option, and eight patients preferred MDOT to clinic DOT or DOT through visiting Community Health Workers.Conclusions: MDOT is technically feasible. Both patients and health professionals appear empowered by the ability to communicate with each other and appear receptive to remote MDOT and health messaging over mobile. Further research should be conducted to evaluate whether MDOT (1) improves medication adherence, (2) is cost effective, and (3) can be used to improve treatment compliance for other diseases such as AIDS. (Am J Prey Med 2010;39(1):78 - 80) (C) 2010 American Journal of Preventive Medicine