Replacing the frequent home visits often necessary for tuberculosis treatment with video visits facilitated by an app appears to be a cost-effective, well-received means of ensuring adherence throughout therapy, according to a recently published pilot study.
Because TB is, airborne, highly infectious, and increasingly resistant to antibiotics, treatment and prevention of the disease often requires patients be isolated at home or have their medication adherence confirmed in-person by a healthcare worker. Various versions of this type of care, known as Directly Observed Therapy (DOT), are frequently mandated by state and federal health agencies alike.
As a result, researchers from Johns Hopkins School of Medicine investigated whether emocha, a video platform spun out of the university that was specifically developed to provide DOT, could offer caregivers and patients an advantage.
"We believe video DOT offers an alternative that appears to be as effective as an in-person daily visits by health care workers to assure compliance with drug treatment, but also empowers patients to manage their TB without added stress," Dr. Samuel Holzman, a research fellow in the department of infectious diseases at the Johns Hopkins University School of Medicine and the study’s lead author, said in a statement.
In the pilot study (which was coauthored by one of emocha Mobile Health’s clinical advisors), researchers tested the video DOT strategy by recruiting 28 adult TB patients across three Maryland clinics. Participants began their treatment with in-person DOT, and had the option to transition to video DOT at any point during their care. All disease treatment decisions were clinic-directed and consistent with state and CDC guidelines.
The researchers observed a 94 percent medication adherence rate among patients when they switched to video DOT, a statistically similar rate to the 98 percent adherence seen among those receiving in-person care (p = .17). The percentage of total treatment doses taken, however, was higher when a patient was using video DOT (72 percent versus 66 percent, p = .03).
During interviews and surveys conducted before and after video DOT implementation, the approach was well received by both patients and medical staff. Specifically, the interviewees said that they felt the intervention was flexible, convenient, and improved patient privacy. Further, a cost analysis conducted by the team estimated that the strategy led to a savings of $1,391 per patient over a six-month treatment course.
“This study confirms what our customers have been saying for years: emocha helps to ensure high rates of medication adherence, saves precious public health resources, and eases burdens for both patients and providers,” Sebastian Seiguer, CEO of emocha Mobile Health, said in a statement