Video observed therapy improves treatment success and adherence in adults with tuberculosis
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Key Takeaway
Consider video observed therapy to improve treatment success and adherence in patients with tuberculosis.
This network meta-analysis synthesized data from 29 randomized controlled trials involving 17,800 participants to evaluate various digital health interventions for tuberculosis treatment success and adherence compared to directly observed therapy. The analysis included modalities such as video observed therapy, medication event reminder monitor systems, and various messaging services.
Key findings indicate that video observed therapy resulted in significantly better outcomes (RR 1.18; 95% CI 1.02-1.37) compared to directly observed therapy. While the overall treatment success rate for digital interventions was statistically higher than direct observation (RR 1.03; 95% CI 1.00-1.07), specific modalities varied in efficacy. For example, double-way short message services showed a lower outcome compared to directly observed therapy (RR 0.80; 95% CI 0.67-0.95). Additionally, video observed therapy was associated with higher adherence rates compared to other interventions.
The authors suggest that video observed therapy should receive greater prominence in clinical care, particularly for patients identified as having low treatment adherence. Limitations regarding the certainty of evidence were not reported, and specific safety data or tolerability metrics were not provided in the analysis.
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View Original Abstract ↓
BackgroundIncomplete adherence to tuberculosis treatment increases the risk of delayed sputum culture conversion in the community, as well as elevated risks of treatment failure, recurrence, and the development or amplification of drug resistance. Through network meta-analysis, we aimed to comprehensively analyze the effects of digital health interventions for patients with tuberculosis.MethodsPubMed, Cochrane Library, Embase and Web of Science for randomized controlled trails that examined the efficacy of digital health intervention for tuberculosis treatment up to 18 May 2026. The main outcome included treatment success and adherence. Stata (version 17) and R software (version 4.3.1) were used for the data analysis.ResultsFrom 17,643 publications, we included 29 randomized controlled trials involving 17,800 participants for quantitative analysis. Overall, digital health interventions showed a statistically higher treatment success rate than directly observed therapy (RR 1.03; 95% CI 1.00–1.07). Then a network meta-analysis of each intervention was conducted. Regarding treatment success, apart from video observed therapy showing significantly better outcomes compared to directly observed therapy (RR 1.18; 95% CI 1.02–1.37) and double-way short message service (RR 0.80; 95% CI 0.67–0.95), there was no statistically significant difference observed between medication event reminder monitor systems, monitors, single-way short message services, double-way short message service, video observed therapy, phone calls, and directly observed therapy. In terms of adherence, video observed therapy also demonstrated significantly higher adherence rates compared to other interventions. Additionally, video observed therapy was ranked as the top digital health intervention for achieving both treatment success and adherence.ConclusionVideo observed therapy has excellent effects on treatment success and adherence than other digital health interventions. Given its excellent efficacy, video observed therapy should be given more prominence in clinical care, especially for individuals with low adherence, where resources allow.
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