V.H.LIM1, L.WAN1, C.ONG1
National Healthcare Group Polyclinics HQ1
Directly observed therapy (DOT) has always been conducted face-to-face for patients with active tuberculosis. Failure to comply with tuberculosis treatment poses public health risk. COVID-19 pandemic has accelerated adoption of tele-health to reduce the risk of infection spreading. Tele-direct observed therapy (Tele-DOT) was implemented to replace face-to-face visits for tuberculosis treatment in primary care setting.
Patients are screened and selected for Tele-DOT should meet the enrolment criteria and have successfully completed at least 3 months of directly observed therapy with 100% adherence. A synchronous video consult is conducted at pre-arranged time to allow the real time observation of patients self-administering their TB medications from home.
In 34 patients, 567 Tele-DOT sessions were conducted since June 2020. There was no reported defaulter nor deterioration in patients’ condition that required recall for face-to-face visit. Patients were 100% compliance to the required treatment plan and reported 100% satisfied with the service. 68% reported difference between Tele-DOT sessions versus face-to-face visit. Some of the reasons cited include verbally counting of pills in front of video camera; time saving from travelling and need to swallow pill one by one.
Tele-DOT provides an alternative to traditional face-to-face visit for tuberculosis treatment yet maintain the level of compliance required in treatment. Patient acceptance of Tele-DOT was high to both patient and nurses. It allowed flexibility in scheduling the time for observed therapy based on patients’ convenience. It also required the careful patient selection to ensure therapy adherence.