Video Supported Treatment (VST)

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Digital Adherence Technologies

Video Supported Treatment (VST)

Video Supported Treatment (VST) allows individuals to video record their medication intake, which the health care provider can watch at a later stage.

DAT users are guided through a secured mobile application to record videos of themselves ingesting their daily medication. This is then uploaded to a secure remote server that can be accessed by the health care provider to review the doses taken.

If a video is not sent when expected, or if the medication intake is unclear in the video, the healthcare worker can contact the DAT user to determine the problem and provide support, to ensure future medication adherence.

Considerations

To determine whether video supported treatment (VST) is suitable for target population and context, certain elements need to be considered.

Each consideration is scored according to a favourability scale as low, medium or high. Low indicating less favourability, and high indicating increased favourability compared to the other digital adherence technologies.

These considerations are based on the ASCENT Project Technical Brief, summarizing the implementation experiences with three technologies in 5 countries.

EASE FOR PATIENT TO USE TECHNOLOGY: LOW
  • Patient needs to record medication intake by video for the entire treatment duration. This is expected to take 3 – 5 minutes each day.
  • Patient may feel uncomfortable about privacy associated with video recording themselves.
EASE FOR HEALTHCARE WORKER TO USE TECHNOLOGY: LOW
  • Provider needs to review and verify each patient medication intake video. This is expected to take 4 – 6 minutes per patient per day. However, this can take longer if there is a video recording error that needs to be followed up on.
ACCESSIBILITY: LOW
  • Patient needs daily access to a smart phone.
  • Patient needs daily access to Wi-Fi or mobile data network.
  • Health care provider requires technology to review videos – a smartphone / tablet or computer as well as data or Wi-Fi.
  • Country legislation on data and privacy may restrict sending, storing, and sharing videos.
EASE OF IMPLEMENTATION: HIGH
  • No specialized in-country infrastructure required.
  • Video recording adherence app can be easily downloaded and installed.
SUITABILITY FOR USE WITH DIFFERENT DRUG TYPES: HIGH
  • Suitable across all medication types.

Implementation Requirements

Smartphone access

Patient has daily access to a smartphone.

Mobile data or Wi-Fi

Patient has daily access to mobile data / Wi-Fi, throughout treatment.

Server

Secure video storage server has been set-up in country.

Adherence platform access for provider

Healthcare provider can use smartphone, tablet, or laptop to access online adherence platform.

Time to review videos

Healthcare provider has sufficient time each day to review patient videos.

Follow-up based on adherence

Targeted follow-up actions and support by healthcare providers and other staff based on adherence.

Country Implementers

Haiti

Patient Target

DS-TB Patients, prisoners / recent parolees

Scale

150

Publications

2018-dec-newsletter.pdf (healththroughwalls.org)

Kenya

Patient Target

DS-TB

Scale

500

DAT Combination

VOT, Medication Sleeve

Mozambique

Patient Target

MDR-TB

Scale

250

Philippines

Patient Target

DS-TB

DR-TB

Scale

20200

Publications

DLSHI-Philippines-DAT-for-URC.pdf (thearcadygroup.com)

Ukraine

Patient Target

DS-TB

DR-TB

Scale

15900

DAT Combination

VOT, Smart Pill Box

Publications

TB REACH Research.pdf (lhsi.org.ua)

Kyrgyzstan

Patient Target

DS-TB

MDR-TB

Scale

100

Nigeria

Patient Target

MDR-TB

Scale

7500

DAT Combination

VOT, Medication Sleeves

Publication

South Africa

Patient Target

DS-TB

DR-TB

XDR-TB (150 patients)

Scale

15150

DAT Combination

VOT, Medication Sleeves, Smart Pill Box

Vietnam

Patient Target

DS-TB

Scale

40

DAT Combination

VOT, Medication Sleeves, Smart Pill Box

Publications

Video Directly Observed Therapy to support adherence with treatment for tuberculosis in Vietnam: A prospective cohort study – PubMed (nih.gov)

Eswatini

Patient Target

MDR-TB patients

Scale

150

India

Patient Target

DS-TB

Scale

12100

DAT Combination

VOT, Medication Sleeves, Smart Pill Box

Publication

PAPINENI-MASTEROFMEDICALSCIENCESTHESIS-2020.pdf (harvard.edu)

Paraguay

Patient Target

DS-TB

Scale

50

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