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Open Access Publications from the University of California

Tuberculosis treatment monitoring by video directly observed therapy in 5 health districts, California, USA

  • Author(s): Garfein, RS
  • Liu, L
  • Cuevas-Mota, J
  • Collins, K
  • Muñoz, F
  • Catanzaro, DG
  • Moser, K
  • Higashi, J
  • Al-Samarrai, T
  • Kriner, P
  • Vaishampayan, J
  • Cepeda, J
  • Bulterys, MA
  • Martin, NK
  • Rios, P
  • Raab, F
  • et al.

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© 2018, Centers for Disease Control and Prevention (CDC). All rights reserved. We assessed video directly observed therapy (VDOT) for monitoring tuberculosis treatment in 5 health districts in California, USA, to compare adherence between 174 patients using VDOT and 159 patients using in-person directly observed therapy (DOT). Multivariable linear regression analyses identified participant-reported sociodemographics, risk behaviors, and treatment experience associated with adherence. Median participant age was 44 (range 18–87) years; 61% of participants were male. Median fraction of expected doses observed (FEDO) among VDOT participants was higher (93.0% [interquartile range (IQR) 83.4%–97.1%]) than among patients receiving DOT (66.4% [IQR 55.1%– 89.3%]). Most participants (96%) would recommend VDOT to others; 90% preferred VDOT over DOT. Lower FEDO was independently associated with US or Mexico birth, shorter VDOT duration, finding VDOT difficult, frequently taking medications while away from home, and having video-recording problems (p<0.05). VDOT cost 32% (range 6%–46%) less than DOT. VDOT was feasible, acceptable, and achieved high adherence at lower cost than DOT.

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