Smartphone app targets TB medication adherence

The University of California-San Diego and the Verizon Foundation have joined forces in the fight against tuberculosis and drug-resistant strains of the bacterium through remote medication adherence monitoring, according to an announcement. Called Video Directly Observed Therapy (VDOT), the technology allows TB patients to video record themselves taking their daily medications on smartphones and send the videos to health departments, which monitor and document each dose of medication remotely. 

"Because poor compliance with TB treatment regimens leads to ongoing disease, acquisition of drug resistant forms of TB, and transmission of TB to community members, health departments in the U.S. spend millions of dollars driving to patients' homes every day to watch them take their pills," states the announcement. "This often stigmatizes patients, limits their mobility and imposes a financial burden on health departments. VDOT provides the same level of adherence monitoring at a fraction of the cost, and with much greater acceptability to patients than in-person observation."

Developed by Richard Garfein, M.D., in collaboration with researchers at the University of California-San Diego's School of Medicine, a team of developers from Qualcomm Institute/Calit2, and public health officials from San Diego and Tijuana, Mexico, VDOT is currently being used by the San Diego County TB Control Program and health departments in San Francisco and New York City will soon begin using the new system. 

In 2012, a National Institutes of Health-funded pilot of VDOT in San Diego and Tijuana found that more than 93 percent of prescribed doses were observed using videos made and sent by the patients, and 100 percent of the patients said they would recommend VDOT to other TB patients. In addition, the program significantly reduced the transportation and staffing costs for the San Diego and Tijuana health departments.

"MHealth applications like VDOT can be game-changers when it comes to accelerating the pace of TB control and eradication," said Dr. Garfein in an announcement. "VDOT significantly reduces the cost and personnel burden of monitoring patient-treatment adherence, allowing healthcare providers to concentrate their limited resources on the patients with the greatest adherence needs."

VDOT leverages Verizon's HIPAA-enabled cloud solution and makes it possible for multiple health departments to use the system to simultaneously monitor TB treatment for thousands of patients. Each participating health department will be able to securely store patients' health information and medication records that are only accessible to the departments' own staff. In addition, the Verizon's HIPAA-enabled cloud gives health departments their first centralized platform to securely exchange information and communicate with their patients. Verizon will also initially provide 300 smartphones that will be distributed to patients at the first three VDOT launch sites.

Last year, the mHealth Alliance and Stop TB Partnership teamed up to prevent tuberculosis and improve care for those already suffering from the condition, according to a report. The document points to a variety of projects that already show that text messages, or other reminders such as automatic call-backs on patients' personal phones can be used to communicate effectively with patients. The report also recommends providing patients with mobile credits or other rewards and incentives to encourage adherence. Similarly, researchers from the University of British Columbia are testing whether SMS/text messaging can help TB patients stick with their drug regimens.

To learn more:
- read the announcement