Video-Observed Therapy as an alternative to Directly-Observed Therapy for active tuberculosis : a prospective study of feasibility and acceptability by patients and nurses in a low-incidence high-income area

Article Article scientifique Article Video-Observed Therapy as an alternative to Directly-Observed Therapy for active tuberculosis : a prospective study of feasibility and acceptability by patients and nurses in a low-incidence high-income area eng 2025-09-01 2025-09-01 author Cantero Chloe Division of Pulmonology, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland. 659616 author Lhonneux Christelle Pulmonary League of Geneva, Geneva, Switzerland. author Vaudaux Amélie 0009-0004-7135-7362 Pulmonary League of Geneva, Geneva, Switzerland. author Gabrielli Sabrina Lydia Pulmonary League of Geneva, Geneva, Switzerland. 503069 author Bergeron Anne 0000-0003-2156-254X Division of Pulmonology, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland. 981702 Département de médecine (DEMED) author Janssens Jean-Paul 0000-0002-9931-7715 Division of Pulmonology, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Pulmonology, La Tour Hospital, Meyrin, Switzerland. 30742 4238 10.57187/s.4238 41100827 1424-3997 https://smw.ch/index.php/smw/article/view/4238/6344 Study aim: Tuberculosis remains a public health issue in Switzerland. Adherence to treatment is a challenge. To promote adherence, Video-Observed Therapy (VOT) has been proposed as an alternative to Directly Observed Therapy (DOT) that is less stigmatising, respects patients' privacy and uses less resources. This study aimed to assess (1) the feasibility and (2) the acceptability of VOT for tuberculosis by patients and specialised nurses in our area. Methods: All subjects aged above 16 years with a newly diagnosed active tuberculosis, irrespective of site of infection, and followed by our centre could be included. Patients were provided with a pictogram-based smartphone app and trained by specialised nurses to send daily videos of their treatment to a secure platform. Acceptability by patients and by specialised nurses, ratio of number of videos sent to those expected and technical issues were prospectively recorded. Results: Over 18 months, 55 patients were invited to participate. Four (7.2%) declined (92.7% acceptance rate). Of the remaining 51, 5 (9.8%) failed to start VOT, thus leaving 46 patients followed by VOT (their median age was 40.3 years with interquartile range [IQR] 33-45; 27 [53%] were female). Three cases (6.5%) dropped out. No cases of multidrug-resistant tuberculosis were documented. The ratio of total number of videos received/ expected (5744/6392) was 89.9%; the median individual ratio of videos sent/received was 96% (IQR: 73-100); the number of videos sent remained stable over 6 months. Of the 5744 videos sent, 312 (5.4%) showed minor technical problems. Results of an 18-item questionnaire showed that VOT was well accepted by our specialised nurses. Conclusions: VOT showed a high rate of acceptance by patients and specialised nurses in our area and appears to be a feasible alternative to DOT. Humans Female Male Prospective Studies Directly Observed Therapy Adult Feasibility Studies Tuberculosis / therapy Tuberculosis / drug therapy Middle Aged Switzerland Patient Acceptance of Health Care / statistics & numerical data Video Recording Antitubercular Agents / therapeutic use Nurses Dewey 616 56 Département de médecine 221 false 1430 Maladies interstitielles et de l'immunodéprimé 1057 Swiss medical weekly 155 13bc1778-ce32-4f4c-8f53-8397425cdcba Article (Published version) Public Article_scientifique_from_unpaywall.pdf 1191646 application/pdf CC BY-4.0 8d70d73d8425786e2d53a1bea54b2fb036838b1aff623b940bb2328a1cd5c929 openAccess Faculté de médecine / Section de médecine clinique / Département de médecine

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Video-Observed Therapy as an alternative to Directly-Observed Therapy for active tuberculosis : a prospective study of feasibility and acceptability by patients and nurses in a low-incidence high-income area	Swiss medical weekly			2025	11	67

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