Tuberculosis treatment adherence in the era of COVID-19
Abstract Background In-person directly observed therapy (DOT) is commonly used for tuberculosis (TB) treatment monitoring in the US, with increasing usage of video-DOT (vDOT). We evaluated the impact of COVID-19 on TB treatment adherence, and utilization and effectiveness of vDOT. Methods We abstrac...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-10-01
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| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12879-022-07787-4 |
| _version_ | 1797991593805873152 |
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| author | Christopher K. Lippincott Allison Perry Elizabeth Munk Gina Maltas Maunank Shah |
| author_facet | Christopher K. Lippincott Allison Perry Elizabeth Munk Gina Maltas Maunank Shah |
| author_sort | Christopher K. Lippincott |
| collection | DOAJ |
| description | Abstract Background In-person directly observed therapy (DOT) is commonly used for tuberculosis (TB) treatment monitoring in the US, with increasing usage of video-DOT (vDOT). We evaluated the impact of COVID-19 on TB treatment adherence, and utilization and effectiveness of vDOT. Methods We abstracted routinely collected data on individuals treated for TB disease in Baltimore, Maryland between April 2019 and April 2021. Our primary outcomes were to assess vDOT utilization and treatment adherence, defined as the proportion of prescribed doses (7 days/week) verified by observation (in-person versus video-DOT), comparing individuals in the pre-COVID and COVID (April 2020) periods. Results Among 52 individuals with TB disease, 24 (46%) received treatment during the COVID-19 pandemic. vDOT utilization significantly increased in the COVID period (18/24[75%]) compared to pre-COVID (12/28[43%], p = 0.02). Overall, median verified adherence was similar pre-COVID and COVID periods (65% versus 68%, respectively, p = 0.96). Adherence was significantly higher overall when using vDOT (median 86% [IQR 70–98%]) compared to DOT (median 59% [IQR 55-64%], p < 0.01); this improved adherence with vDOT was evident in both the pre-COVID (median 98% vs. 58%, p < 0.01) and COVID period (median 80% vs. 62%, p = 0.01). Conclusion vDOT utilization increased during the COVID period and was more effective than in-person DOT at verifying ingestion of prescribed treatment. |
| first_indexed | 2024-04-11T08:54:41Z |
| format | Article |
| id | doaj.art-0363c170dbeb419b82464c0c3cc211cd |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-04-11T08:54:41Z |
| publishDate | 2022-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-0363c170dbeb419b82464c0c3cc211cd2022-12-22T04:33:19ZengBMCBMC Infectious Diseases1471-23342022-10-012211610.1186/s12879-022-07787-4Tuberculosis treatment adherence in the era of COVID-19Christopher K. Lippincott0Allison Perry1Elizabeth Munk2Gina Maltas3Maunank Shah4Division of Infectious Diseases, Johns Hopkins School of MedicineDivision of Epidemiology, Department of Population Health, New York University School of MedicineDivision of Infectious Diseases, Johns Hopkins School of MedicineDivision of Infectious Diseases, Johns Hopkins School of MedicineDivision of Infectious Diseases, Johns Hopkins School of MedicineAbstract Background In-person directly observed therapy (DOT) is commonly used for tuberculosis (TB) treatment monitoring in the US, with increasing usage of video-DOT (vDOT). We evaluated the impact of COVID-19 on TB treatment adherence, and utilization and effectiveness of vDOT. Methods We abstracted routinely collected data on individuals treated for TB disease in Baltimore, Maryland between April 2019 and April 2021. Our primary outcomes were to assess vDOT utilization and treatment adherence, defined as the proportion of prescribed doses (7 days/week) verified by observation (in-person versus video-DOT), comparing individuals in the pre-COVID and COVID (April 2020) periods. Results Among 52 individuals with TB disease, 24 (46%) received treatment during the COVID-19 pandemic. vDOT utilization significantly increased in the COVID period (18/24[75%]) compared to pre-COVID (12/28[43%], p = 0.02). Overall, median verified adherence was similar pre-COVID and COVID periods (65% versus 68%, respectively, p = 0.96). Adherence was significantly higher overall when using vDOT (median 86% [IQR 70–98%]) compared to DOT (median 59% [IQR 55-64%], p < 0.01); this improved adherence with vDOT was evident in both the pre-COVID (median 98% vs. 58%, p < 0.01) and COVID period (median 80% vs. 62%, p = 0.01). Conclusion vDOT utilization increased during the COVID period and was more effective than in-person DOT at verifying ingestion of prescribed treatment.https://doi.org/10.1186/s12879-022-07787-4Video DOTmHealthTuberculosisMedication adherenceTelemedicine |
| spellingShingle | Christopher K. Lippincott Allison Perry Elizabeth Munk Gina Maltas Maunank Shah Tuberculosis treatment adherence in the era of COVID-19 BMC Infectious Diseases Video DOT mHealth Tuberculosis Medication adherence Telemedicine |
| title | Tuberculosis treatment adherence in the era of COVID-19 |
| title_full | Tuberculosis treatment adherence in the era of COVID-19 |
| title_fullStr | Tuberculosis treatment adherence in the era of COVID-19 |
| title_full_unstemmed | Tuberculosis treatment adherence in the era of COVID-19 |
| title_short | Tuberculosis treatment adherence in the era of COVID-19 |
| title_sort | tuberculosis treatment adherence in the era of covid 19 |
| topic | Video DOT mHealth Tuberculosis Medication adherence Telemedicine |
| url | https://doi.org/10.1186/s12879-022-07787-4 |
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