Evaluation of recorded video-observed therapy for anti-tuberculosis treatment
Evaluation of recorded video-observed therapy for anti-tuberculosis treatment
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DOI：
10.5588/ijtld.19.0456
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发表时间：
2020-05-01
影响因子：
4
通讯作者：
Rios, P.
中科院分区：
文献类型：
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作者：
Garfein, R. S.;Liu, L.;Rios, P.
背景：异步视频直接观察治疗（VDOT）可以减少结核病（TB）项目的成本和患者的负担。我们比较了美国三个城市的 VDOT 表现，每个城市的结核病发病率均高于全国平均水平。 方法：邀请目前正在接受直接观察抗结核治疗的年龄 >= 18 岁的患者使用 VDOT 来监测治疗。使用治疗前和治疗后访谈和医疗记录来评估治疗依从性以及患者特征和认知方面的地点差异。 结果：参与者在纽约州纽约市 (n = 48)、加利福尼亚州圣地亚哥 (n = 52) 和美国加利福尼亚州旧金山 (n = 49) 入组。总体而言，平均年龄为 41 岁（范围 18-87 岁）； 59%为男性；大多数是亚洲人 (45%) 或西班牙裔/拉丁裔 (30%)； 77% 是外国出生的。观察到的预期剂量 (FEDO) 的中位数为 88% (IQR 76-96)。在随访中，97% 的人认为 VDOT“非常或有些容易使用”，95% 的人会向其他结核病患者推荐 VDOT。年龄、种族/族裔、年收入和出生国家因城市而异（P < 0.05），但 FEDO 和 VDOT 的认知却没有差异。结论：美国三个大城市的结核病项目在使用 VDOT 的同时最大限度地减少了工作人员的时间和旅行，观察到较高的 FEDO。各站点的类似发现支持其他大型城市结核病项目采用 VDOT。
BACKGROUND: Asynchronous video directly observed therapy (VDOT) may reduce tuberculosis (TB) program costs and the burden on patients. We compared VDOT performance across three cities in the United States, each of which have TB incidence rates above the national average.METHODS: Patients aged >= 18 years who are currently receiving directly observed anti-TB treatment were invited to use VDOT for monitoring treatment. Pre- and post-treatment interviews and medical records were used to assess site differences in treatment adherence and patient characteristics and perceptions.RESULTS: Participants were enrolled in New York City, NY (n = 48), San Diego, CA (n = 52) and San Francisco, CA, USA (n = 49). Overall, the mean age was 41 years (range 18-87); 59% were male; most were Asian (45%) or Hispanic/Latino (30%); and 77% were foreign-born. The median fraction of expected doses observed (FEDO) was 88% (IQR 76-96). At follow-up, 97% thought VDOT was "very or somewhat easy to use" and 95% would recommend VDOT to other TB patients. Age, race/ethnicity, annual income, and country of birth differed by city (P < 0.05), but FEDO and VDOT perceptions did not.CONCLUSIONS: TB programs in three large US cities observed a high FEDO using VDOT while minimizing staff time and travel. Similar findings across sites support VDOT adoption by other large, urban TB programs.