Coivd-19 has increased the importance of remote treatment, but is it as effective?
The effectiveness of Video Observed Therapy (VOT) has rarely been measured in LMICs, where more than 95% of TB cases and deaths occur. In our study, we analysed the effectiveness, and patient cost-difference, of VOT compared to clinic-based Directly Observed Therapy (DOT) in improving medication adherence in Moldova, a LMIC in Eastern Europe.
The study was a 2-arm individually randomised trial with 197 TB patients (n=99 in DOT control group; 98 in VOT treatment group, MDR-TB cases were excluded). The primary outcome was observed medication adherence, measured by the number of days that a patient failed to be observed adhering to medication for every two-week period during the course of their treatment
In this trial, Video Observed Therapy (VOT) increased observed medication adherence for tuberculosis patients in Moldova, a LMIC, when compared to clinic-based Directly Observed Therapy (DOT). VOT also significantly reduced the time and money patients spent on their treatment.
Ravenscroft, L., Kettle, S., Persian, R., Ruda, S., Severin, L., Doltu, S., ... & Loewenstein, G. (2020). Video observed therapy (VOT) and medication adherence for TB patients: RCT in Moldova. European Respiratory Journal.