JMIR Publications

ABSTRACT

Background:

Despite the development of effective drugs for treatment, tuberculosis (TB) remains one of the leading causes of death from an infectious disease worldwide. One of the greatest challenges to TB control is patient adherence to treatment. Recent research has shown that video-based Directly Observed Therapy (DOT) is a feasible and effective approach to supporting treatment adherence in high income settings. However, few studies have explored the potential for such a solution in a low- or middle-income country setting. Globally, these countries’ rapidly rising rate of mobile penetration suggests that the potential for translation of these results may be high. We sought to evaluate patient perceptions related to the use of mobile health, and specifically Video Observed Therapy (VOT), in a previously unstudied patient demographic: TB patients in a low-income country setting (Cambodia).

Objective:

We sought to evaluate patient perceptions related to the use of mobile health, and specifically Video Observed Therapy (VOT), in a previously unstudied patient demographic: TB patients in a low-income country setting (Cambodia).

Methods:

We conducted a cross sectional qualitative study in urban and peri-urban areas in Cambodia, consisting of six focus groups with TB patients currently receiving treatment (standard DOT) through a non-governmental organization.

Results:

Familiarity with mobile technology and applications was universal in this population, and overall willingness to consider a mobile app for VOT was high. However, potential challenges were identified. First, patients very much value their frequent in-person interactions with their healthcare provider, which may be reduced with the VOT intervention. Second, there may be technical issues to address, including how to make the app suitable for illiterate participants.

Conclusions:

While VOT is a promising technology, even in country settings where mobile penetration is reportedly almost universal, introduction should be undertaken with caution. However, the results are generally promising and yield important insights which will not only be translated into the further adaptation of key features of VOT for TB patients in Cambodia but can also inform the future design and successful implementation of VOT interventions in low- and middle-income settings more generally.