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Related Experiment Video

Updated: Sep 4, 2025

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Programmatic Adoption and Implementation of Video-Observed Therapy in Minnesota: Prospective Observational Cohort

Preetham Bachina¹, Christopher Kirk Lippincott¹, Allison Perry²

¹Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD, United States.

JMIR Formative Research

|July 14, 2022

Summary

Video-DOT (vDOT) significantly improved tuberculosis treatment adherence compared to in-person DOT. This technology adoption increased post-COVID-19, enhancing verified adherence despite the pandemic.

Keywords:

COVID-19 mHealth medication adherence mobile health observed therapy primary outcome technology adoption telehealth telemedicine treatment treatment adherence tuberculosis vDOT video directly observed therapy virtual health

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Published on: February 12, 2020

Area of Science:

Public Health
Infectious Diseases
Health Technology

Background:

Directly Observed Therapy (DOT) is the standard for tuberculosis (TB) treatment adherence monitoring in the US.
Video-DOT (vDOT) offers a scalable alternative, with adoption increasing since 2019 in Minneapolis.

Purpose of the Study:

To evaluate the effectiveness of vDOT versus in-person DOT for TB treatment adherence.
To assess the impact of COVID-19 on vDOT adoption and TB treatment adherence.

Main Methods:

Retrospective analysis of TB patient data from Minneapolis (September 2019 - June 2021).
Comparison of verified adherence rates between vDOT and in-person DOT.
Analysis of adherence trends across pre-COVID-19, early COVID-19, and intra-COVID-19 periods.

Main Results:

vDOT showed significantly higher verified adherence (81%) than in-person DOT (54.5%).
vDOT adoption increased from 35% pre-COVID-19 to 67% post-COVID-19.
Overall verified adherence improved across study periods (56% to 79%).

Conclusions:

vDOT is more effective than in-person DOT in verifying TB treatment adherence.
Increased vDOT use post-COVID-19 contributed to improved overall adherence.
vDOT implementation enhanced treatment monitoring despite the challenges posed by the COVID-19 pandemic.