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1638. Synchronous Video Observed Therapy for Monitoring Treatment of Tuberculosis: Experience in a Cases Series from Cali, Colombia, 2019
BACKGROUND: In Directly Observed Treatment (DOT) monitoring strategy for the treatment of tuberculosis (TB), the patient has to travel daily to the health institution to take the TB medication. Although has been usefulness, this strategy increases the catastrophic costs of the disease, rising the pr...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7777032/ http://dx.doi.org/10.1093/ofid/ofaa439.1818 |
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author | Tello-Cajiao, Maria E Mosquera Hernandez, Juan Camilo C Ardila-Giraldo, Santiago Romero-Rosas, Nelson Parra-Lara, Luis Niño, Yessenia Luna, Lucy García-Goez, Jose |
author_facet | Tello-Cajiao, Maria E Mosquera Hernandez, Juan Camilo C Ardila-Giraldo, Santiago Romero-Rosas, Nelson Parra-Lara, Luis Niño, Yessenia Luna, Lucy García-Goez, Jose |
author_sort | Tello-Cajiao, Maria E |
collection | PubMed |
description | BACKGROUND: In Directly Observed Treatment (DOT) monitoring strategy for the treatment of tuberculosis (TB), the patient has to travel daily to the health institution to take the TB medication. Although has been usefulness, this strategy increases the catastrophic costs of the disease, rising the probability of rejection, abandonment, and failure to treatment. Therefore, a monitoring strategy was implemented through video calls phone known as Synchronous Video Observed Therapy (S-VOT), to document the experience and its results in a series of patients from a low-middle income country. METHODS: A prospective case series study was conducted involving 23 TB patients managed with standard treatment, who were supervised through daily video call phone, during 2019, Cali-Colombia. Adherence to VOT strategy and treatment were evaluated, as well as patient characteristics, adverse drug effects, perception and costs. Categorical variable data were summarized in absolute and relative frequency tables. Quantitative variables were described with median and Interquartile range. Proportional differences were calculated with Z test, risk opportunities and difference of medians with Mann Whitney’s U test were performed. We take p values < 0.05 as significant. RESULTS: Adherence to S-VOT monitoring strategy was 99.8% in first phase of treatment and 98.2% in second phase. All patients completed treatment, achieving 100% cure criteria in patients with pulmonary TB. Most adverse drug effects were reported on first month (31.6%, p=0.003). Skin changes were the most frequent complaint at the beginning of management (16.4%) and epigastralgia at the end (20%). The likelyhood of adverse effects was significantly reduced when patients started maintenance phase on third month (OR: 0.29, p = 0.0003). The experience of the strategy was generally positive for patients. Time savings was major advantage. Travel costs in S-VOT were lower than DOT for patients, as well as the daily time investment in TB treatment. CONCLUSION: S-VOT strategy was well tolerated and accepted by all patients, allowing an excellent level of adherence, with reduction in travel costs and investment of time for treatment. S-VOT is proposed as a viable alternative to DOT in selected patients. DISCLOSURES: All Authors: No reported disclosures |
format | Online Article Text |
id | pubmed-7777032 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-77770322021-01-07 1638. Synchronous Video Observed Therapy for Monitoring Treatment of Tuberculosis: Experience in a Cases Series from Cali, Colombia, 2019 Tello-Cajiao, Maria E Mosquera Hernandez, Juan Camilo C Ardila-Giraldo, Santiago Romero-Rosas, Nelson Parra-Lara, Luis Niño, Yessenia Luna, Lucy García-Goez, Jose Open Forum Infect Dis Poster Abstracts BACKGROUND: In Directly Observed Treatment (DOT) monitoring strategy for the treatment of tuberculosis (TB), the patient has to travel daily to the health institution to take the TB medication. Although has been usefulness, this strategy increases the catastrophic costs of the disease, rising the probability of rejection, abandonment, and failure to treatment. Therefore, a monitoring strategy was implemented through video calls phone known as Synchronous Video Observed Therapy (S-VOT), to document the experience and its results in a series of patients from a low-middle income country. METHODS: A prospective case series study was conducted involving 23 TB patients managed with standard treatment, who were supervised through daily video call phone, during 2019, Cali-Colombia. Adherence to VOT strategy and treatment were evaluated, as well as patient characteristics, adverse drug effects, perception and costs. Categorical variable data were summarized in absolute and relative frequency tables. Quantitative variables were described with median and Interquartile range. Proportional differences were calculated with Z test, risk opportunities and difference of medians with Mann Whitney’s U test were performed. We take p values < 0.05 as significant. RESULTS: Adherence to S-VOT monitoring strategy was 99.8% in first phase of treatment and 98.2% in second phase. All patients completed treatment, achieving 100% cure criteria in patients with pulmonary TB. Most adverse drug effects were reported on first month (31.6%, p=0.003). Skin changes were the most frequent complaint at the beginning of management (16.4%) and epigastralgia at the end (20%). The likelyhood of adverse effects was significantly reduced when patients started maintenance phase on third month (OR: 0.29, p = 0.0003). The experience of the strategy was generally positive for patients. Time savings was major advantage. Travel costs in S-VOT were lower than DOT for patients, as well as the daily time investment in TB treatment. CONCLUSION: S-VOT strategy was well tolerated and accepted by all patients, allowing an excellent level of adherence, with reduction in travel costs and investment of time for treatment. S-VOT is proposed as a viable alternative to DOT in selected patients. DISCLOSURES: All Authors: No reported disclosures Oxford University Press 2020-12-31 /pmc/articles/PMC7777032/ http://dx.doi.org/10.1093/ofid/ofaa439.1818 Text en © The Author 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Poster Abstracts Tello-Cajiao, Maria E Mosquera Hernandez, Juan Camilo C Ardila-Giraldo, Santiago Romero-Rosas, Nelson Parra-Lara, Luis Niño, Yessenia Luna, Lucy García-Goez, Jose 1638. Synchronous Video Observed Therapy for Monitoring Treatment of Tuberculosis: Experience in a Cases Series from Cali, Colombia, 2019 |
title | 1638. Synchronous Video Observed Therapy for Monitoring Treatment of Tuberculosis: Experience in a Cases Series from Cali, Colombia, 2019 |
title_full | 1638. Synchronous Video Observed Therapy for Monitoring Treatment of Tuberculosis: Experience in a Cases Series from Cali, Colombia, 2019 |
title_fullStr | 1638. Synchronous Video Observed Therapy for Monitoring Treatment of Tuberculosis: Experience in a Cases Series from Cali, Colombia, 2019 |
title_full_unstemmed | 1638. Synchronous Video Observed Therapy for Monitoring Treatment of Tuberculosis: Experience in a Cases Series from Cali, Colombia, 2019 |
title_short | 1638. Synchronous Video Observed Therapy for Monitoring Treatment of Tuberculosis: Experience in a Cases Series from Cali, Colombia, 2019 |
title_sort | 1638. synchronous video observed therapy for monitoring treatment of tuberculosis: experience in a cases series from cali, colombia, 2019 |
topic | Poster Abstracts |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7777032/ http://dx.doi.org/10.1093/ofid/ofaa439.1818 |
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