Use of video directly observed treatment for tuberculosis in Northern Norway

Background In 2017, a total of 261 patients with tuberculosis were reported in Norway, whereof 90 % completed their therapy. Anti-tuberculosis drugs are administered as daily directly observed treatment (DOT) to all patients. We investigated whether this could be done by video conference. Material and method We conducted a clinical observation study at the University Hospital of North Norway in the period 2016-2019, in which patients ≥ 16 years with tuberculosis after a minimum of two weeks of daily DOT during home visits continued their treatment through video conference (video DOT). The password-protected and encrypted video conference service provided by Norwegian Healthnet was used. The home care service contacted the patient by video conference in real time and observed the intake of drugs via a tablet computer, smartphone or PC. Results 20 out of 30 patients met the inclusion criteria, whereof 17 patients (15 foreign-born) with a median age of 32 (17-74) were included. The average observed drug intake per patient was 86.1 % in the period with home-based DOT and 75.9 % in the period with video DOT. The median daily time spent by the home care service was 17 (2-40) minutes for home visits and 3 (1-8) minutes for video conferences. Fourteen out of 17 patients and 14 out of 17 home nurses preferred video conferencing over home visits. Fifteen patients and all home care nurses would recommend video conferencing to others. Technical problems (8.9 %) were the most common reason for directly observed treatment not being undertaken during the period with video conferencing. Interpretation Video DOT was feasible for the selected patients. Video conferencing was time-efficient for the home care service and was preferable to home visits.