Healthcare workers watch TB patients take meds with app

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A pilot study of a video-based smartphone app at three tuberculosis clinics in Maryland has demonstrated that using the technology can serve as a substitute for a daily in-person visit by a healthcare worker, which is required for TB treatment.

Results of the preliminary study, published in the journal Open Forum Infectious Diseases by Johns Hopkins School of Medicine researchers, showed that the smartphone app may be less costly and improve privacy concerns raised by tuberculosis patients compared to in-person visits.

U.S. health departments mandate that healthcare workers directly observe TB patients taking their medications in order to document that they were taken correctly and to monitor for side-effects. However, in-person directly observed therapy (DOT) is resource intensive and often burdensome for patients. Video DOT (vDOT), on the other hand, is proving to be a flexible alternative.

In the pilot, the app—developed by emocha Mobile Health and clinicians at Johns Hopkins University School of Medicine—was used by 28 adult TB patients who had their therapy monitored through vDOT instead of in-person visits by a healthcare worker.

Overall, patient adherence to treatment was nearly the same for vDOT (94 percent) and in-person DOT (98 percent). In addition, the overall proportion of prescribed doses that were verified through observation was 6 percent higher with vDOT versus in-person DOT.

“We believe video DOT offers an alternative that appears to be as effective as an in-person daily visits by healthcare workers to assure compliance with drug treatment, but also empowers patients to manage their TB without added stress,” says Samuel Holzman, MD, a research fellow in the department of infectious diseases at the Johns Hopkins University School of Medicine.

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According to Holzman, TB therapy takes a minimum of six months and requires multiple medications, which can be challenging for patients. However, in the study, 100 percent of the patients reported that the emocha Mobile Health platform was “easy to use” and preferred it to in-person DOT.

Researchers also discovered that when compared to five-day per week in-person visits, vDOT was estimated to cost an average of $674 per patient versus $2,065 for in-person DOT—a savings of $1,391 per patient for a standard six-month treatment course.

“emocha’s video DOT platform is a novel, patient-centric complement to in-person visits,” said Sebastian Seiguer, CEO of emocha Mobile Health. “This study confirms what our customers have been saying for years: emocha helps to ensure high rates of medication adherence, saves precious public health resources, and eases burdens for both patients and providers.”

Under a license agreement between emocha Mobile Health and Johns Hopkins, the university is entitled to royalties on the technology. In addition, the university owns shares of emocha Mobile Health stock.

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