MedPage Today (09.09.2013)
A British pilot study suggested that video-taping a TB patient taking medication might be a cost- effective way of monitoring compliance to cut down on drug resistance. The World Health Organization recommended a trained person directly observe TB patients swallow their medication either at a clinic or at the patient’s home. Dr. Marc Lipman of University College London and colleagues found this “virtual observation” strategy might be an effective tool when a patient could not or would not participate in direct observance because of complicating factors such as homelessness, drug abuse, or transportation issues.
The researchers gave patients laptops or smartphones to video themselves holding the medication, swallowing the medication, and then showing an open mouth with no medication remaining for every dose. The patients then sent the video clip to their healthcare provider. Lipman said seven of the 17 patients chosen for the pilot complied with the requirements and finished treatments or were close to completion. “Something like one in three individuals who would require directly observed treatment, I think would succeed with virtually observed treatment,” Lipman said at a press conference. “It's not perfect for everyone but it does seem to be effective.” The remaining 10 patients did not participate for various reasons.
The main advantage of virtually observing medication adherence would be the money to be saved, Lipman stated. “If you've got a complex patient, by and large you get them through treatment, but the cost associated with it we estimate is something like 25 to 50 times the standard TB treatment cost, just because they are so resource intensive,” he said and added that Britain was planning a national trial, with cost-effectiveness being an important issue.
The full report, " Using Virtually Observed Treatment (VOT) for Hard to Manage Tuberculosis: A Pilot Study," was presented at a conference of the European Respiratory Society (ERS 2013; Abstract P1601).