Virtual Monitoring Could Aid Adherence to TB Medication

Virtual observation of patients taking their prescribed tuberculosis (TB) medication could prove an effective technique for ensuring patients effectively complete their course of treatment. The research was presented on Sept. 8, 2013 at the European Respiratory Society (ERS) Annual Congress.

The new study suggests an alternative method to directly observed treatment (DOT), which is recommended by the World Health Organization. Directly observing treatments is often time consuming for a patient and is resource intensive for outreach projects, which seek to help people who may not wish to visit a clinic.

The virtually observed treatment (VOT) method instead requires people to send a short video of them taking their medication, to their healthcare provider using a mobile phone. After an initial visit to the clinic, this can be completed remotely, with any issues being followed up when required.

Researchers from the Royal Free London NHS Foundation Trust piloted the effectiveness of the VOT technique. Nine people needing DOT commenced the program. Two people returned no clips during the first week and were returned to the clinic-based approach. Of the remaining seven, six people returned video clips for a minimum of 95 percent of all treatment encounters.

Overall, the researchers observed 86 percent of scheduled doses. They concluded that this was a feasible method of monitoring TB treatment programmes in people able to use VOT.

Lead author Sara Hemming says, "These preliminary findings suggest that telemedicine can help us overcome the difficulties we've seen in directly monitoring patients taking their medicine. Some people are unable or unwilling to visit clinics for a variety of reasons, but by enabling healthcare professionals to virtually monitor patients, we can still ensure effective medication use without the need for a one-to-one session. This has the potential to not only reach people who are otherwise unengaged, but also reduce costs and resources. A larger trial comparing the two techniques is needed to ensure the safety and reliability of this technique, and also determine who benefits most from this approach."

European Respiratory Society president Francesco Blasi says,  "The European Lung White Book, which is launched this week, calls on countries with high rates of TB, to set up strategies to manage the large numbers of people with drug-susceptible and multidrug-resistant-TB (MDR-TB). This study shows one way that could improve the effectiveness of treatments for people who are particularly hard-to-reach. The outcomes of this pilot study are positive and I look forward to seeing the results of a larger trial."