Effectiveness and Acceptability of Video-Observed Therapy for Tuberculosis Treatment Monitoring: A Scoping Review
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Abstract
Background: Tuberculosis (TB) control programs confront a significant challenge in ensuring patients fully adhere to their treatment regimens. Video-observed therapy (VOT) is an alternative digital technology for monitoring tuberculosis treatment that may potentially improve adherence and clinical outcomes. However, there is limited evidence supporting the effectiveness and acceptability of VOT. This scoping review aimed to summarize the characteristics of existing evidence-based VOT for tuberculosis treatment monitoring and to describe the evidence for their effectiveness and acceptability.
Methods: This review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping review protocol in Jan 2023. Three databases, namely PubMed, Web of Science, and SCOPUS, were used in this review.
Results: The search identified 170 articles, and after the identification and screening process, 22 articles were included in this review. The findings were categorized into effectiveness and acceptability.
Conclusion: There is a progressively growing body of evidence, particularly in treating and monitoring TB using VOT, which has a positive impact on improving effectiveness regarding health outcomes and is widely accepted to implement. Future studies, such as non-inferiority trials and cost-effectiveness evaluations, will help improve tuberculosis strategies and management.
1. World Health Organization (2022). Global Tuberculosis Report 2020. https://www.who.int/teams/global-tuberculosis-programme/tb-reports
2. Vernon A, Fielding K, Savic R, et al (2019). The importance of adherence in tuber-culosis treatment clinical trials and its relevance in explanatory and pragmatic trials. PLoS Med, 16(12): e1002884.
3. World Health Organization (2015). The End TB Strategy. https://www.who.int/teams/global-tuberculosis-programme/the-end-tb-strategy
4. Karumbi J, Garner P (2015). Directly ob-served therapy for treating tuberculosis. Cochrane Database Syst Rev, 2015(5):CD003343
5. Marahatta SB, Yadav RK, Giri D, et al (2020). Barriers in the access, diagnosis and treatment completion for tubercu-losis patients in central and western Nepal: A qualitative study among pa-tients, community members and health care workers. PLoS One, 15(1): e0227293.
6. Kamble BD, Sunil Kumar Singh SJ, Chel-laiyan, et al (2020). Social stigma among tuberculosis patients attending DOTS centers in Delhi. J Family Med Prim Care, 9(8):4223–8.
7. Murphy A, Palafox B, Walli-Attaei M, et al (2020). The household economic burden of non-communicable diseases in 18 countries. BMJ Glob Health, 5(2): e002040.
8. Story A, Aldridge RW, Smith CM, et al (2019). Smartphone-enabled video-observed versus directly observed treatment for tuberculosis: a multicentre, analyst-blinded, randomised, controlled superiority trial. Lancet, 393 (10177): 1216–24.
9. Perski O, Short CE (2021). Acceptability of digital health interventions: embracing the complexity. Transl Behav Med, 11(7):1473–80
10. Hicks JP, Allsop MJ, Akaba GO, et al (2021). Acceptability and Potential Ef-fectiveness of eHealth Tools for Train-ing Primary Health Workers from Nige-ria at Scale: Mixed Methods, Uncon-trolled Before-and-After Study. JMIR Mhealth Uhealth, 9(9): e24182
11. Davis FD (1989). Perceived Usefulness, perceived ease of use and user ac-ceptance of information technology. MIS Q, 13(3):319-340.
12. Ngwatu BK, Nsengiyumva NP, Oxlade O, et al (2018). The impact of digital health technologies on tuberculosis treatment: A systematic review. Eur Respir J, 51(1):1701596.
13. Truong CB, Tanni KA, Qian J (2022). Vid-eo-Observed Therapy Versus Directly Observed Therapy in Patients with Tu-berculosis. Am J Prev Med, 62(3):450–8.
14. Tricco AC, Lillie E, Zarin W, et al (2018). PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explana-tion. Ann Intern Med, 169(7):467–73.
15. City University of London (2023). Ad-vanced literature search and systematic review https://libguides.city.ac.uk/systematic-reviews/formulate-your-question
16. Wade VA, Karnon J, Eliott JA, et al (2012). Home Videophones Improve Direct Observation in Tuberculosis Treatment: A Mixed Methods Evaluation. PLoS One, 7(11): e50155.
17. Guo P, Qiao W, Sun Y, et al (2020). Tele-medicine technologies and tuberculosis management: A randomized controlled trial. Telemed J E Health, 26(9):1150–6.
18. Mirsaeidi M, Farshidpour M, Banks-Tripp D, et al (2015). Video directly observed therapy for treatment of tuberculosis is patient-oriented and cost-effective. Eur Respir J, 46(3):871–4.
19. Chuck C, Robinson E, Macaraig M, et al (2016). Enhancing management of tu-berculosis treatment with video directly observed therapy in New York City. Int J Tuberc Lung Dis, 20(5):588–93.
20. Lam CK, Fluegge K, Macaraig M, et al (2019). Cost savings associated with vid-eo directly observed therapy for treat-ment of tuberculosis. Int J Tuberc Lung Dis, 23(11):1149–54.
21. Bendiksen R, Ovesen T, Asfeldt A-M, et al (2020). Use of video directly observed treatment for tuberculosis in Northern Norway. Tidsskr Nor Laegeforen, 140(1).
22. Burzynski J, Mangan JM, Lam CK, et al (2022). In-Person vs Electronic Directly Observed Therapy for Tuberculosis Treatment Adherence: A Randomized Noninferiority Trial. JAMA Netw Open, 5(1): e2144210.
23. Guo X, Yang Y, Takiff HE, et al (2020). A comprehensive app that improves tu-berculosis treatment management through video-observed therapy: Usabil-ity study. JMIR Mhealth Uhealth, 8(7): e17658.
24. Garfein RS, Liu L, Cuevas-mota J, et al (2018). Tuberculosis Treatment Monitor-ing by Video Directly Observed Thera-py in 5 Health Districts, California, USA. Emerg Infect Dis, 24(10): 1806-1815.
25. Amoo S, Samuel AO, Bosun T, et al (2021). Impact of a Digital Health Platform (NimCure) on Adherence Enhancement in Tuberculosis Therapy. African Scientist, 22(2):49–57.
26. Perry A, Chitnis A, Chin A, et al (2021). Re-al-world implementation of video-observed therapy in an urban TB pro-gram in the United States. Int J Tuberc Lung Dis, 25(8):655–61.
27. Bachina P, Lippincott CK, Perry A, et al (2022). Programmatic Adoption and Im-plementation of Video-Observed Ther-apy in Minnesota: Prospective Observa-tional Cohort Study. JMIR Form Res, 6(8): e38247.
28. Holzman SB, Zenilman A, Shah M. (2018) Advancing patient-centered care in tu-berculosis management: A mixed-methods appraisal of video directly ob-served therapy. Open Forum Infect Dis, 5(4): ofy046.
29. Ravenscroft L, Kettle S, Persian R, et al (2020). Video-observed therapy and medication adherence for tuberculosis patients: Randomised controlled trial in Moldova. Eur Respir J, 56(2): 2000493.
30. Garfein RS, Collins K, Muñoz F, et al (2015). Feasibility of tuberculosis treat-ment monitoring by video directly ob-served therapy: A binational pilot study. Int J Tuberc Lung Dis, 19(9):1057–64.
31. Lam CK, Pilote KMG, Haque A, et al (2018). Using video technology to increase treatment completion for patients with latent tuberculosis infection on 3-month isoniazid and rifapentine: An imple-mentation study. J Med Internet Res, 20(11):e287.
32. Sekandi JN, Buregyeya E, Zalwango S, et al (2020). Video directly observed therapy for supporting and monitoring adher-ence to tuberculosis treatment in Ugan-da: A pilot cohort study. ERJ Open Res, 6(1): 00175-2019.
33. Garfein RS, Liu L, Cuevas-Mota J, et al (2020). Evaluation of recorded video-observed therapy for anti-tuberculosis treatment. Int J Tuberc Lung Dis, 24(5):520–5.
34. Nguyen TA, Pham MT, Nguyen TL, et al (2017). Video Directly Observed Thera-py to support adherence with treatment for tuberculosis in Vietnam: A prospec-tive cohort study. Int J Infect Dis, 65:85–9.
35. Holzman SB, Atre S, Sahasrabudhe T, et al (2019). Use of smartphone-based video directly observed therapy (vDOT) in tu-berculosis care: single-arm, prospective feasibility study. JMIR Form Res, 3(3): e13411.
36. Sekandi JN, Kasiita V, Onuoha NA, et al (2021). Stakeholders’ perceptions of benefits of and barriers to using video-observed treatment for monitoring pa-tients with tuberculosis in Uganda: Ex-ploratory qualitative study. JMIR Mhealth Uhealth, 9(10): e27131.
37. Kumwichar P, Chongsuvivatwong V, Prap-pre T (2022). Video-Observed Therapy with a Notification System for Improv-ing the Monitoring of Tuberculosis Treatment in Thailand: Usability Study. JMIR Form Res, 6(5): e35994.
38. Kendall EA, Azman AS, Cobelens FG, et al (2017). MDR-TB treatment as preven-tion: The projected population-level impact of expanded treatment for mul-tidrug-resistant tuberculosis. PLoS One, 12(3): e0172748.
39. Alipanah N, Jarlsberg L, Miller C, et al (2018). Adherence interventions and outcomes of tuberculosis treatment: A systematic review and meta-analysis of trials and observational studies. PLoS Med, 15(7): e1002595.
40. Fekadu G, Jiang X, Yao J, et al (2021). Cost-effectiveness of video-observed therapy for ambulatory management of active tuberculosis during the COVID-19 pan-demic in a high-income country. Int J Infect Dis, 113:271–8.
41. Nsengiyumva NP, Mappin-Kasirer B, Ox-lade O, et al (2018). Evaluating the po-tential costs and impact of digital health technologies for tuberculosis treatment support. Eur Respir J, 52(5): 1801363.
42. Campbell JI, Eyal N, Musiimenta A, et al (2016). Ethical Questions in Medical Electronic Adherence Monitoring. J Gen Intern Med, 31(3):338–42.
43. Saunders MJ, Wingfield T, Tovar MA, et al (2018). Mobile phone interventions for tuberculosis should ensure access to mobile phones to enhance equity – A prospective, observational cohort study in Peruvian shantytowns. Trop Med Int Health, 23(8):850–9.
2. Vernon A, Fielding K, Savic R, et al (2019). The importance of adherence in tuber-culosis treatment clinical trials and its relevance in explanatory and pragmatic trials. PLoS Med, 16(12): e1002884.
3. World Health Organization (2015). The End TB Strategy. https://www.who.int/teams/global-tuberculosis-programme/the-end-tb-strategy
4. Karumbi J, Garner P (2015). Directly ob-served therapy for treating tuberculosis. Cochrane Database Syst Rev, 2015(5):CD003343
5. Marahatta SB, Yadav RK, Giri D, et al (2020). Barriers in the access, diagnosis and treatment completion for tubercu-losis patients in central and western Nepal: A qualitative study among pa-tients, community members and health care workers. PLoS One, 15(1): e0227293.
6. Kamble BD, Sunil Kumar Singh SJ, Chel-laiyan, et al (2020). Social stigma among tuberculosis patients attending DOTS centers in Delhi. J Family Med Prim Care, 9(8):4223–8.
7. Murphy A, Palafox B, Walli-Attaei M, et al (2020). The household economic burden of non-communicable diseases in 18 countries. BMJ Glob Health, 5(2): e002040.
8. Story A, Aldridge RW, Smith CM, et al (2019). Smartphone-enabled video-observed versus directly observed treatment for tuberculosis: a multicentre, analyst-blinded, randomised, controlled superiority trial. Lancet, 393 (10177): 1216–24.
9. Perski O, Short CE (2021). Acceptability of digital health interventions: embracing the complexity. Transl Behav Med, 11(7):1473–80
10. Hicks JP, Allsop MJ, Akaba GO, et al (2021). Acceptability and Potential Ef-fectiveness of eHealth Tools for Train-ing Primary Health Workers from Nige-ria at Scale: Mixed Methods, Uncon-trolled Before-and-After Study. JMIR Mhealth Uhealth, 9(9): e24182
11. Davis FD (1989). Perceived Usefulness, perceived ease of use and user ac-ceptance of information technology. MIS Q, 13(3):319-340.
12. Ngwatu BK, Nsengiyumva NP, Oxlade O, et al (2018). The impact of digital health technologies on tuberculosis treatment: A systematic review. Eur Respir J, 51(1):1701596.
13. Truong CB, Tanni KA, Qian J (2022). Vid-eo-Observed Therapy Versus Directly Observed Therapy in Patients with Tu-berculosis. Am J Prev Med, 62(3):450–8.
14. Tricco AC, Lillie E, Zarin W, et al (2018). PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explana-tion. Ann Intern Med, 169(7):467–73.
15. City University of London (2023). Ad-vanced literature search and systematic review https://libguides.city.ac.uk/systematic-reviews/formulate-your-question
16. Wade VA, Karnon J, Eliott JA, et al (2012). Home Videophones Improve Direct Observation in Tuberculosis Treatment: A Mixed Methods Evaluation. PLoS One, 7(11): e50155.
17. Guo P, Qiao W, Sun Y, et al (2020). Tele-medicine technologies and tuberculosis management: A randomized controlled trial. Telemed J E Health, 26(9):1150–6.
18. Mirsaeidi M, Farshidpour M, Banks-Tripp D, et al (2015). Video directly observed therapy for treatment of tuberculosis is patient-oriented and cost-effective. Eur Respir J, 46(3):871–4.
19. Chuck C, Robinson E, Macaraig M, et al (2016). Enhancing management of tu-berculosis treatment with video directly observed therapy in New York City. Int J Tuberc Lung Dis, 20(5):588–93.
20. Lam CK, Fluegge K, Macaraig M, et al (2019). Cost savings associated with vid-eo directly observed therapy for treat-ment of tuberculosis. Int J Tuberc Lung Dis, 23(11):1149–54.
21. Bendiksen R, Ovesen T, Asfeldt A-M, et al (2020). Use of video directly observed treatment for tuberculosis in Northern Norway. Tidsskr Nor Laegeforen, 140(1).
22. Burzynski J, Mangan JM, Lam CK, et al (2022). In-Person vs Electronic Directly Observed Therapy for Tuberculosis Treatment Adherence: A Randomized Noninferiority Trial. JAMA Netw Open, 5(1): e2144210.
23. Guo X, Yang Y, Takiff HE, et al (2020). A comprehensive app that improves tu-berculosis treatment management through video-observed therapy: Usabil-ity study. JMIR Mhealth Uhealth, 8(7): e17658.
24. Garfein RS, Liu L, Cuevas-mota J, et al (2018). Tuberculosis Treatment Monitor-ing by Video Directly Observed Thera-py in 5 Health Districts, California, USA. Emerg Infect Dis, 24(10): 1806-1815.
25. Amoo S, Samuel AO, Bosun T, et al (2021). Impact of a Digital Health Platform (NimCure) on Adherence Enhancement in Tuberculosis Therapy. African Scientist, 22(2):49–57.
26. Perry A, Chitnis A, Chin A, et al (2021). Re-al-world implementation of video-observed therapy in an urban TB pro-gram in the United States. Int J Tuberc Lung Dis, 25(8):655–61.
27. Bachina P, Lippincott CK, Perry A, et al (2022). Programmatic Adoption and Im-plementation of Video-Observed Ther-apy in Minnesota: Prospective Observa-tional Cohort Study. JMIR Form Res, 6(8): e38247.
28. Holzman SB, Zenilman A, Shah M. (2018) Advancing patient-centered care in tu-berculosis management: A mixed-methods appraisal of video directly ob-served therapy. Open Forum Infect Dis, 5(4): ofy046.
29. Ravenscroft L, Kettle S, Persian R, et al (2020). Video-observed therapy and medication adherence for tuberculosis patients: Randomised controlled trial in Moldova. Eur Respir J, 56(2): 2000493.
30. Garfein RS, Collins K, Muñoz F, et al (2015). Feasibility of tuberculosis treat-ment monitoring by video directly ob-served therapy: A binational pilot study. Int J Tuberc Lung Dis, 19(9):1057–64.
31. Lam CK, Pilote KMG, Haque A, et al (2018). Using video technology to increase treatment completion for patients with latent tuberculosis infection on 3-month isoniazid and rifapentine: An imple-mentation study. J Med Internet Res, 20(11):e287.
32. Sekandi JN, Buregyeya E, Zalwango S, et al (2020). Video directly observed therapy for supporting and monitoring adher-ence to tuberculosis treatment in Ugan-da: A pilot cohort study. ERJ Open Res, 6(1): 00175-2019.
33. Garfein RS, Liu L, Cuevas-Mota J, et al (2020). Evaluation of recorded video-observed therapy for anti-tuberculosis treatment. Int J Tuberc Lung Dis, 24(5):520–5.
34. Nguyen TA, Pham MT, Nguyen TL, et al (2017). Video Directly Observed Thera-py to support adherence with treatment for tuberculosis in Vietnam: A prospec-tive cohort study. Int J Infect Dis, 65:85–9.
35. Holzman SB, Atre S, Sahasrabudhe T, et al (2019). Use of smartphone-based video directly observed therapy (vDOT) in tu-berculosis care: single-arm, prospective feasibility study. JMIR Form Res, 3(3): e13411.
36. Sekandi JN, Kasiita V, Onuoha NA, et al (2021). Stakeholders’ perceptions of benefits of and barriers to using video-observed treatment for monitoring pa-tients with tuberculosis in Uganda: Ex-ploratory qualitative study. JMIR Mhealth Uhealth, 9(10): e27131.
37. Kumwichar P, Chongsuvivatwong V, Prap-pre T (2022). Video-Observed Therapy with a Notification System for Improv-ing the Monitoring of Tuberculosis Treatment in Thailand: Usability Study. JMIR Form Res, 6(5): e35994.
38. Kendall EA, Azman AS, Cobelens FG, et al (2017). MDR-TB treatment as preven-tion: The projected population-level impact of expanded treatment for mul-tidrug-resistant tuberculosis. PLoS One, 12(3): e0172748.
39. Alipanah N, Jarlsberg L, Miller C, et al (2018). Adherence interventions and outcomes of tuberculosis treatment: A systematic review and meta-analysis of trials and observational studies. PLoS Med, 15(7): e1002595.
40. Fekadu G, Jiang X, Yao J, et al (2021). Cost-effectiveness of video-observed therapy for ambulatory management of active tuberculosis during the COVID-19 pan-demic in a high-income country. Int J Infect Dis, 113:271–8.
41. Nsengiyumva NP, Mappin-Kasirer B, Ox-lade O, et al (2018). Evaluating the po-tential costs and impact of digital health technologies for tuberculosis treatment support. Eur Respir J, 52(5): 1801363.
42. Campbell JI, Eyal N, Musiimenta A, et al (2016). Ethical Questions in Medical Electronic Adherence Monitoring. J Gen Intern Med, 31(3):338–42.
43. Saunders MJ, Wingfield T, Tovar MA, et al (2018). Mobile phone interventions for tuberculosis should ensure access to mobile phones to enhance equity – A prospective, observational cohort study in Peruvian shantytowns. Trop Med Int Health, 23(8):850–9.
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| Issue | Vol 54 No 3 (2025) | |
| Section | Review Article(s) | |
| Keywords | ||
| Video-observed therapy Effectiveness Adherence Acceptability | ||
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How to Cite
1.
Othman R, Safian N, Hassan MR. Effectiveness and Acceptability of Video-Observed Therapy for Tuberculosis Treatment Monitoring: A Scoping Review. Iran J Public Health. 2025;54(3):499-508.
