Programmatic adoption and implementation of Video-observed therapy in Minnesota: Prospective Observational Cohort Study (Preprint)

• DOI: 10.2196/preprints.38247
• Publication Date: 2022-04-05T16:47:21Z
• Authors: Preetham Bachina; Christopher Kirk ...; Allison Perry; Elizabeth Munk; Gina Maltas; Rebecca Bohr; Robert Bryan Rock; Maunank Shah
• Keywords: Directly Observed Therapy

<sec> <title>BACKGROUND</title> In-person directly observed therapy (DOT) is commonly used for tuberculosis (TB) treatment adherence monitoring in the US, with increasing usage of video-DOT (vDOT). In Minneapolis, vDOT became available 2019. </sec> <title>OBJECTIVE</title> We aimed to evaluate programmatic utilization and effectiveness over time, impact COVID-19 on TB technology adoption. <title>METHODS</title> abstracted routinely collected data individuals receiving disease MN between September 2019 June 2021. Our primary outcomes were assess adherence, defined as proportion prescribed doses (7 days per week) verified by observation (in-person versus video-DOT), comparing pre-COVID (before March 2020), early-COVID (March-August intra-COVID (after August 2020) period. <title>RESULTS</title> Among 49 patients (mean age 41, 55% female, 96% non-US born), 18 (36.7%) received during pandemic. Overall, (proportion doses) was significantly higher when using (median 86% [IQR 71-99%]) compared in-person DOT 57% [47%-63%], P=.001). The adoption increased from 35% period, 67% post-COVID periods (P=.035). Consequently, overall (i.e., observed) among all clinic improved across study (56%, 67%, 79%, P=.001 pre-, early-, periods, respectively). <title>CONCLUSIONS</title> post-COVID, more effective than at verifying ingestion treatment, led despite onset