7th SA TB Conference 2022 Oral Presentation
Track 3: Implementation/Health systems
Authors: Siyabonga Myeni, Munira Khan, Suzanne Staples
Video Observed Therapy (VOT) is an innovative digital treatment support technology that employs live or recorded video monitoring dosing via a smartphone, tablet or computer.
Among VOT implementors and MDR-TB patients on a TB clinical trial in KwaZulu-Natal, South Africa:
- To measure acceptability and feasibility of VOT,
- To identify barriers and enablers
- A complementary concurrent mixed-methods design was used:
- Quantitative survey captured participants’ demographic information, access to and ability to use technology and the usage of VOT.
- Qualitative component consisted of in-depth interviews with implementors to gather perceptions and experiences and patient focus group discussions for patient experiences.
- The Technology Acceptance Model provided the framework for data collection tools
- Twenty-nine patients participated:
- 80% were male
- Aged 25 – 34 (41%), 35 – 44 (38%) and 45 – 54 (21%) years.
- Enablers supporting implementation:
- 92% agreed that using VOT would help them complete treatment.
- 97% felt more connected to their healthcare provider through VOT.
- VOT also provided patients with greater flexibility compared to DOT.
- Barriers to implementation:
- Poor mobile network coverage in rural areas,
- Load shedding,
- Loss of VOT-allocated mobile devices through crime.
Results: VOT Implementors
- Seventeen VOT implementors participated in the study who were all THINK employees.
- Clinical VOT implementors reported that:
- VOT enabled the provision of better support and counselling (71%) and easy identification of poorly-adherent patients (82%).
- VOT provided more reliable treatment support data compared to DOT; which further informed clinical management decisions.
- This study showed that VOT was an acceptable and feasible treatment treatment support strategy both amongst implementors and patients.
- However, the use of VOT was limited to a clinical trial setting within THINK and use in public sector settings and further implementation science studies are therefore needed.