@Article{info:doi/10.2196/29463, author="Kumwichar, Ponlagrit and Chongsuvivatwong, Virasakdi and Prappre, Tagoon", title="Development of a Video-Observed Therapy System to Improve Monitoring of Tuberculosis Treatment in Thailand: Mixed-Methods Study", journal="JMIR Form Res", year="2021", month="Jul", day="27", volume="5", number="7", pages="e29463", keywords="app; mixed-methods analysis; remote monitoring; therapy; tuberculosis; user experience; video directly observed therapy; video-enhanced therapy; video-observed therapy", abstract="Background: Directly observed therapy programs for monitoring tuberculosis (TB) treatment in Thailand are unsustainable, especially during the COVID-19 pandemic. The current video-observed therapy (VOT) system, the Thai VOT (TH VOT), was developed to replace the directly observed therapy program. Objective: This study aimed to describe the VOT system design and identify the potential for system improvements. Methods: This pilot study was conducted in Na Yong district, a small district in Trang province, south of Thailand. The TH VOT system consists of a smartphone app for patients, a secured web-based platform for staff, items used, and standard operating procedures. There were three groups of users: observers who were TB staff, healthy volunteers as simulated patients, and patients with active TB. All participants were trained to follow the standard operating procedures. After 2-week usage, VOT session records were analyzed to measure the compliance of the patients and observers. The User Experience Questionnaire was used to lead the participant users to focus on 6 standard dimensions of usability, and was supplemented with an in-depth interview to identify potential system improvements from users' experience. Results: Only 2 of 16 patients with currently active TB had a usable smartphone. Sixty of 70 drug-taking sessions among 2 patients and 3 simulated patients in 2 weeks were recorded and uploaded. Only 37 sessions were inspected by the observers within 24 hours. All participants needed a proper notification system. An audit system was also requested. Conclusions: Before upscaling, the cost of smartphone lending, audit management, and notification systems should be elucidated. ", issn="2561-326X", doi="10.2196/29463", url="https://formative.jmir.org/2021/7/e29463", url="https://doi.org/10.2196/29463", url="http://www.ncbi.nlm.nih.gov/pubmed/34313602" }