| Truong CB, Tanni KA, Qian J.* |
Systematic review and meta-analysis |
TB program settings in Australia, China, Moldova, United Kingdom, and United States |
Synchronous or asynchronous vDOT compared with community or clinic-based in-person DOT |
Patients being treated for TB or LTBI for 4–9 mos |
Adherence |
Patient took ≥80% of prescribed doses |
vDOT 360/457 (78.8%) patients:
in-person DOT 106/390 (27.2%) patients |
RR (95% CI) = 2.79 (2.26 to 3.45) |
Better outcome with vDOT compared with in-person DOT |
| Treatment completion |
Patient did not prematurely stop treatment or was not lost to follow-up |
vDOT 124/157 (79.0%) patients;
in-person DOT 436/639 (68.2%) patients |
RR (95% CI) = 1.33 (0.73 to 2.43) |
vDOT and in-person DOT are equivalent |
| Microbiologic resolution |
Radiography and negative sputum smear in the last month of treatment and on one or more previous occasions among patients who were sputum smear positive at beginning of treatment |
vDOT 304/327 (93.0%) patients;
in-person DOT 289/329 (87.8%) patients |
RR (95% CI) = 1.06 (1.01 to 1.11) |
Better outcome with vDOT compared with in-person DOT |
| Perry A, Chitnis A, Chin A, et al.† |
Prospective observational study |
Urban TB program, Alameda County Public Health Department, California |
Asynchronous vDOT compared with community-based in-person DOT |
Patients receiving care for TB treatment during 2018–2020 |
Adherence |
Proportion of total prescribed doses verified by observation with weekend and holiday self-administration§ |
vDOT 68.4% of doses;
in-person DOT 53.9% of doses |
p<0.001 |
Better outcome with vDOT compared with in-person DOT |
| Treatment completion |
Treatment completion and success were based on ingesting a set number of target doses |
vDOT 96% of patients;
in-person DOT 90% of patients |
p = 0.326 |
vDOT and in-person DOT are equivalent |
| Microbiologic resolution |
Mean days to culture conversion among patients who were sputum smear positive at beginning of treatment |
vDOT 48 days;
in-person DOT 47 days |
p = 0.843 |
vDOT and in-person DOT are equivalent |
| Burzynski J, Mangan JM, Lam CK, et al.¶ |
Randomized controlled trial |
Urban TB program in four clinics, NYC DOHMH, New York |
Synchronous and asynchronous vDOT compared with community and clinic-based in-person DOT |
173 patients in 8-wk crossover periods |
Adherence |
Percentage of medication doses participants were observed to completely ingest |
vDOT 89.8% of doses;
in-person DOT 87.2% of doses** |
Percentage difference†† (95% CI) = −2.6% (−4.8% to −0.3%) |
vDOT and in-person DOT are equivalent (trial used a noninferiority design) |
