Researchers at Baltimore-based Johns Hopkins and UC San Diego are developing mobile technologies that let patients track medication intake on their smartphones —a new tool proving useful in fighting tuberculosis, STAT reports.
Encrypted videos taken on smartphones are sent to public health workers who can watch them from work as opposed to traveling to visit patients who are far away.
TB patients must be carefully monitored for a minimum of six months to ensure they don't miss doses that could let the infection survive, mutate into drug-resistant strains and spread in highly populated areas.
"It gives patients a lot more autonomy," said Richard Garfein, PhD, founder of San-Diego-based mobile technology company SureAdhere and a pioneer in using mobile phone technology to monitor TB patients. "It has made their lives a lot easier and illuminated some of the barriers they face."
To address the challenges of controlling TB along the border, where patients with the disease often cross from California into Mexico, Dr. Garfein's team looked to asynchronous observation.
Through this method, patients use phones to record themselves at any time or place and upload the videos to a secure server where a public health worker can view them daily.
Dr. Garfein's group launched a two-year study in 2010 of video-monitored observation of 52 patients in San Diego and Tijuana, Mexico. The study found 93 percent and 96 percent of patients in those cities, respectively, adhered to their drug regimens while using video monitoring over an average of 5.5 months.
The rates are comparable to patients monitored through in-person therapy. A different study in New York City reported an adherence rate of 95 percent for patients using video monitoring, compared to 91 percent for patients who had in-person visits.
The video app could prove to be most effective in developing countries with much higher TB incidence rates and governments that lack treatment resources and often can't verify patients are taking medicines.
The CDC and the World Health Organization released handbooks to support using video observation to improve medication adherence, but say its use should be carefully calculated. Video observation may not be a viable solution for transient populations or those in countries that lack access to the technology and reliable internet access.
The technology is spreading in the U.S., where studies found high adherence rates and savings for public health departments by using video observation. Agencies adopted SureAdhere and similar products made by Emocha Mobile Health and AiCure, bringing the technology to San Francisco and New York as well as rural and urban counties in Texas and Colorado.