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Medientyp:
E-Artikel
Titel:
Video-observed therapy and medication adherence for tuberculosis patients: randomised controlled trial in Moldova
Beteiligte:
Ravenscroft, Luke;
Kettle, Stewart;
Persian, Ruth;
Ruda, Simon;
Severin, Lilian;
Doltu, Svetlana;
Schenck, Benjamin;
Loewenstein, George
Erschienen:
European Respiratory Society (ERS), 2020
Erschienen in:
European Respiratory Journal, 56 (2020) 2, Seite 2000493
Sprache:
Englisch
DOI:
10.1183/13993003.00493-2020
ISSN:
0903-1936;
1399-3003
Entstehung:
Anmerkungen:
Beschreibung:
IntroductionThe effectiveness of video-observed therapy (VOT) for treating tuberculosis (TB) has not been measured in low- and middle-income countries (LMICs), where >95% of TB cases and deaths occur. In this study, we analyse 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.MethodsThe study was a two-arm individually randomised trial with 197 TB patients (n=99 DOT control group; n=98 VOT treatment group; multidrug-resistant 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 2-week period during the course of their treatment.ResultsVOT significantly decreased nonadherence by 4 days (95% CI 3.35–4.67 days, p<0.01) per 2-week period: 5.24 days missed per 2-week period for DOT and 1.29 days for VOT. VOT patients spent MDL 504 (∼EUR 25) (95% CI MDL 277–730, p<0.01) and 58 h (95% CI 48–68 h, p<0.01) less on their treatment. In addition, VOT increased self-reported satisfaction with treatment. We found no significant results pertaining to treatment success, patient wellbeing or patient employment status and some evidence of an increase in side-effects.DiscussionIn this trial, VOT increased observed medication adherence for TB patients in Moldova, a LMIC, when compared to clinic-based DOT. Additionally, VOT significantly reduced the time and money patients spent on their treatment.