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| Name | Class |
|---|---|
| University Hospital, Geneva | OTHER |
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Tuberculosis (TB) is still present in Switzerland, and concerns mainly foreign-born subjects. Monitoring compliance to treatment by Directly Observed Therapy (DOT) is strongly encouraged by the World Health Organization (WHO). It is however time-consuming, costly and stigmatising. This study aims to examine the feasibility of monitoring compliance through a secured web platform and videos sent via an application on a cellphone, a concept known as vDOT (Video-observed therapy). The study aims to include all patients treated for tuberculosis is on our area during an 18 month period and monitor acceptance, compliance, and technical issues related to vDOT.
The study aims to include all patients who are treated de novo for active tuberculosis is our area. The aim of this study, was to show that vDOT was feasible in a low-incidence high income area, that it had a high acceptance rate among patients and health-care professionals, with a low rate of technical difficulties or pitfalls.
All patients with a diagnosis of tuberculosis irrespective of site(s) of infection, were invited to participate in this study. The Division of Pulmonology of Geneva University Hospital diagnoses and follows virtually all cases of tuberculosis in the Canton of Geneva. Annual number of cases in Geneva between 2020 and 2023 was on average 43/year (range: 36-53). Incidence was 7-10.3/105 inhabitants compared to a national incidence of 3.99-4.72 /105 inhabitants during the same period.
Specialized TB nurses were trained to use the vDOT platform and provided the training with the help of translators whenever required. The application (APP) was installed with the patient, and a test video was sent to the platform. The APP uses simple understandable pictograms and is thus not per se language-dependent . vDOT was started as soon as possible after initiation of TB treatment, either during a hospital stay or during the first outpatient follow-up visit at our centre. Whenever necessary, a portable cell phone was provided for the patient, for the duration of the treatment.
The SureAdhere platform was used for vDOT (https://dimagi.com/sureadhere/). Once the videos have been recorded, they are sent automatically as soon as the patients' cell phone has access to internet.
For each patient, the number of videos to be sent each week was specified (5 as default option).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Study group | Experimental | The study is not randomised; all subjects included are submitted to the VOT |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Video-observed therapy (vDOT) | Device | All participants are required to send 5 times per week a short video showing they are actually taking their treatment for tuberculosis via a dedicated application on their cellphone |
| Measure | Description | Time Frame |
|---|---|---|
| Acceptance rate | Number of patients accepting to install the application on their cellphone and send videos of their treatment until treatment completion, among all patients initiating a treatment for active tuberculosis in our center | Two weeks after starting TB treatment |
| Effective implementation rate | Number of patients for whom installing the application, and learning how to use it was possible among all patients with active TB during study period | Two weeks after starting TB treatment |
| Measure | Description | Time Frame |
|---|---|---|
| Ratio of number of videos sent to number of videos expected | Number of videos recorded on the secured platform compared with number expected(% x number of weeks of treatment) | Duration of treatment (max 12 months) |
| Quality of videos sent |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jean-Paul Janssens, MD | University Hospital, Geneva | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Geneva University Hospital | Geneva | Canton of Geneva | 1205 | Switzerland |
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| ID | Term |
|---|---|
| D014376 | Tuberculosis |
| D010349 | Patient Compliance |
| D023801 | Directly Observed Therapy |
| ID | Term |
|---|---|
| D009164 | Mycobacterium Infections |
| D000193 | Actinomycetales Infections |
| D016908 | Gram-Positive Bacterial Infections |
| D001424 | Bacterial Infections |
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All patients with active tuberculosis were invited to participate in the study and followed during the duration of their treatment until treatment completion
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Proportion of videos with technical problems (sound, lighting, framing) was recorded
| Duration of treatment (max 12 months) |
| Evaluation of video-observed therapy by specialized nurses following the patients | Questionnaire with Likert scales submitted to all nurses at the end of the study | End of study (18 months) |
| D001423 | Bacterial Infections and Mycoses |
| D007239 | Infections |
| D010342 | Patient Acceptance of Health Care |
| D000074822 | Treatment Adherence and Compliance |
| D015438 | Health Behavior |
| D001519 | Behavior |
| D055118 | Medication Adherence |