London School of Hygiene & Tropical Medicine

Led by University College London, this study compared patients with tuberculosis (TB) that were using video observed treatment (VOT) with smartphones or directly observed treatment (DOT) and attending clinical appointments.

In total 226 patients took part in the study, of which 58% had a history of homelessness, mental health issues, imprisonment or addiction - TB rates are often higher in these at-risk groups.

Of the group using smartphones to track their treatment, seven out of 10 completed 80% of their scheduled treatments, compared to less than half of patients who were being monitored at face-to-face appointments. The group using smartphones also maintained their treatment for longer.

Making sure patients adhere to TB treatment can be problematic as some patients do not fulfil the six month course of medication, which is vital in curing TB. Is video monitoring an effective way to improve adherence to TB treatment and support patients?

Professor Katherine Fielding, Director of the TB Centre at the London School of Hygiene & Tropical Medicine, said:

“This is an interesting study demonstrating that VOT can improve adherence to TB treatment, which is defined as completing at least 80% of scheduled treatment observations over a two month period. This is critical in the care of patients with TB.

“E-health approaches for improving adherence to TB treatment are currently being explored in many settings, and VOT is one of these approaches.

“It is impressive that 70% of patients in the VOT arm of the study had favorable outcomes compared with 31% of those in the directly observed treatment arm. However, it is important to note that this observation method would not suit all patients.

“While these are encouraging results, the next steps need to look at whether this treatment observation method leads to better clinical results for patients, such as improving end of TB treatment outcomes and reducing subsequent TB recurrence.”