Video supported treatment among vulnerable populations with tuberculosis: Data from prospective multi-centre...

Video supported treatment (VST) is intended as a complementary or alternative approach to directly observed treatment (DOT) in patients with tuberculosis (TB) contributing to treatment adherence and patient follow-up. This study aimed to evaluate efficacy of VST using emocha mobile app (Emocha Mobile Health Inc, Baltimore, MD, USA) in the cohort of vulnerable TB patients in Catalonia, Spain.

We conducted a prospective, multi-centre, single-arm, pilot implementation, study with a matched simultaneous comparison group using VST as a complementary tool to in-person DOT. Treatment adherence was measured as the proportion of validated videos over the total number expected. Odds ratios (OR) and adjusted odds ratios (aOR) assessed associations between patient characteristics and treatment success.

Between December 2019 and January 2023, a total of 83 (14.4%) out of 577 initially screened TB patients were enrolled receiving VST. A total of 12,346 (80.8%) video records were validated from 15,280 being scheduled. 13 out of 83 (15.7%) patients were hospitalised and then switched to in-person DOT for later treatment completion. The rate of successful treatment outcomes among patients utilizing VST either exclusively or in combination with in-person DOT was 91.6% (76/83) while 8.4% (7/83) were loss to follow-up. The success rate increased by 5% (95%CI 2-8) per each percentage point increase in the proportion of time under VST out of the total treatment duration, according to the logistic regression analysis.

When combined with in-person DOT, VST may increase the proportion of observed doses and the likelihood of treatment success.