Volume 24, Number 10—October 2018
Research
Tuberculosis Treatment Monitoring by Video Directly Observed Therapy in 5 Health Districts, California, USA
Richard S. Garfein
, Lin Liu, Jazmine Cuevas-Mota, Kelly Collins, Fatima Muñoz, Donald G. Catanzaro, Kathleen Moser, Julie Higashi, Teeb Al-Samarrai, Paula Kriner, Julie Vaishampayan, Javier Cepeda, Michelle A. Bulterys, Natasha K. Martin, Phillip Rios, and Fredric Raab
, Lin Liu, Jazmine Cuevas-Mota, Kelly Collins, Fatima Muñoz, Donald G. Catanzaro, Kathleen Moser, Julie Higashi, Teeb Al-Samarrai, Paula Kriner, Julie Vaishampayan, Javier Cepeda, Michelle A. Bulterys, Natasha K. Martin, Phillip Rios, and Fredric Raab
Table 2
Reported experiences of patients participating in a study assessing VDOT for monitoring tuberculosis treatment, by site, 5 California health districts, 2015–2016*
| Characteristic |
Total |
Site |
p value† |
||||
|---|---|---|---|---|---|---|---|
| San Diego |
San Francisco |
Santa Clara |
Imperial |
San Joaquin |
|||
| No. patients |
274‡ |
100 |
99 |
49 |
11 |
15 |
|
| VDOT use | |||||||
| Months on VDOT, median (IQR) | 5.4 (3.5–7.1) | 5.2 (3.2–6.3) | 5.4 (3.5–7.3) | 5.5 (4.1–8.1) | 4.0 (2.1–5.6) | 6.1 (4.4–7.7) | 0.08 |
| FEDO, median (SD), IQR |
93.0 (13.5), 83–97 |
88.7 (15.1), 77–94 |
95.5 (11.8), 87–98 |
95.2 (10.3), 89–98 |
84.5 (20.0), 78–94 |
96.1 (7.9), 93–98 |
<0.001 |
| No. patients in follow-up interviews |
214 |
74 |
84 |
39 |
9 |
7 |
|
| Tuberculosis and treatment perceptions | |||||||
| Did you share your VDOT experience with family members? | |||||||
| Yes | 156 (73) | 55 (74) | 55 (66) | 30 (77) | 9 (100) | 6 (86) | 0.18 |
| No | 58 (27) | 19 (26) | 29 (34) | 9 (23) | 0 | 1 (14) | |
| Did you share your VDOT experience with friends, neighbors, classmates, or coworkers? | |||||||
| Yes | 73 (34) | 24 (32) | 28 (33) | 13 (33) | 3 (33) | 5 (71) | 0.38 |
| No | 141 (66) | 50 (68) | 57 (67) | 26 (67) | 6 (67) | 2 (29) | |
| Were you concerned someone would see you using the VDOT cell phone? | |||||||
| Yes | 73 (34) | 19 (26) | 34 (40) | 15 (38) | 4 (44) | 1 (14) | 0.23 |
| No | 141 (66) | 55 (74) | 51 (60) | 24 (62) | 5 (56) | 6 (86) | |
| Did you ever fail to record a video because you were worried someone was watching you? | |||||||
| Yes | 18 (8) | 7 (9) | 9 (11) | 2 (5) | 0 | 0 | 0.87 |
| No | 196 (92) | 67 (91) | 76 (89) | 37 (95) | 9 (100) | 7 (100) | |
| Confidentiality of VDOT vs. DOT? | |||||||
| More | 146 (70) | 49 (67) | 55 (66) | 30 (77) | 7 (78) | 5 (83) | 0.68 |
| Less | 5 (2) | 2 (3) | 1 (1) | 2 (5) | 0 | 0 | |
| Same |
59 (28) |
22 (30) |
27 (33) |
7 (18) |
2 (22) |
1 (17) |
|
| VDOT experience | |||||||
| Overall, how easy/difficult did you find the VDOT process? | |||||||
| Very easy | 174 (81) | 58 (78) | 68 (79) | 36 (92) | 6 (67) | 6 (86) | 0.19 |
| Somewhat easy | 32 (15) | 14 (19) | 13 (15) | 3 (8) | 1 (11) | 1 (14) | |
| Somewhat or very difficult | 9 (4) | 2 (3) | 5 (6) | 0 | 2 (22) | 0 | |
| If you had to redo tuberculosis treatment, would you choose VDOT or DOT? | |||||||
| VDOT | 192 (90) | 67 (92) | 75 (87) | 35 (90) | 9 (100) | 6 (86) | |
| DOT | 6 (3) | 1 (1) | 4 (5) | 1 (3) | 0 | 0 | 0.9 |
| No preference | 16 (7) | 5 (7) | 7 (8) | 3 (8) | 0 | 1 (14) | |
| Would you recommend VDOT to other tuberculosis patients? | |||||||
| Yes | 202 (96) | 70 (95) | 81 (96) | 35 (97) | 9 (100) | 7 (100) | 0.95 |
| No | 8 (4) | 4 (5) | 3 (4) | 1 (3) | 0 | 0 | |
| How often did you take tuberculosis medication away from home? | |||||||
| Never or rarely | 120 (56) | 39 (53) | 54 (64) | 19 (49) | 5 (56) | 3 (43) | 0.36 |
| Less than half or half the time | 48 (22) | 18 (24) | 12 (14) | 13 (33) | 2 (22) | 3 (43) | |
| Most of the time or every time | 46 (21) | 17 (23) | 19 (22) | 7 (18) | 2 (22) | 1 (14) | |
| How often did you have problems using the VDOT application? | |||||||
| Never | 82 (38) | 24 (32) | 41 (48) | 16 (41) | 1 (11) | 0 | 0.06 |
| Rarely | 99 (46) | 35 (47) | 33 (39) | 20 (51) | 5 (56) | 6 (86) | |
| Less than half the time | 23 (11) | 9 (12) | 9 (11) | 2 (5) | 2 (22) | 1 (14) | |
| Half the time or more | 10 (5) | 6 (8) | 2 (2) | 1 (3) | 1 (11) | 0 | |
| How often did poor reception cause you problems uploading videos? | |||||||
| Never | 65 (31) | 13 (18) | 34 (40) | 12 (31) | 3 (33) | 3 (43) | |
| Rarely | 103 (49) | 41 (56) | 35 (42) | 20 (51) | 3 (33) | 4 (57) | 0.15 |
| Less than half the time | 24 (11) | 11 (15) | 7 (8) | 3 (8) | 3 (33) | 0 | |
| Half the time or more | 20 (9) | 8 (11) | 8 (10) | 4 (10) | 0 | 0 | |
*Values are no. (%) participants unless otherwise indicated. DOT, directly observed therapy; FEDO, fraction of expected doses observed = number of complete doses observed via VDOT divided by the number of doses expected; IQR, interquartile range; VDOT, video directly observed therapy.
†p values based on Fisher exact test or Kruskal-Wallis test. Variable totals might not sum to column totals because of missing data.
‡Includes 2 participants who used VDOT but had missing baseline interview data.
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Page updated: September 16, 2018
Page reviewed: September 16, 2018
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