%0 Journal Article
%@ 2561-326X
%I JMIR Publications
%V 5
%N 7
%P e29463
%T Development of a Video-Observed Therapy System to Improve Monitoring of Tuberculosis Treatment in Thailand: Mixed-Methods Study
%A Kumwichar,Ponlagrit
%A Chongsuvivatwong,Virasakdi
%A Prappre,Tagoon
%+ Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Kanjanavanich Rd, Kho Hong, Hat Yai District, Songkhla, 90110, Thailand, 66 74451165, cvirasak@medicine.psu.ac.th
%K app
%K mixed-methods analysis
%K remote monitoring
%K therapy
%K tuberculosis
%K user experience
%K video directly observed therapy
%K video-enhanced therapy
%K video-observed therapy
%D 2021
%7 27.7.2021
%9 Original Paper
%J JMIR Form Res
%G English
%X 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. 
%M 34313602
%R 10.2196/29463
%U https://formative.jmir.org/2021/7/e29463
%U https://doi.org/10.2196/29463
%U http://www.ncbi.nlm.nih.gov/pubmed/34313602