Tuberculosis

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To improve tuberculosis (TB) treatment adherence and minimize the risk of developing drug resistant TB, health agencies worldwide recommend “directly observed therapy” (DOT) to ensure that patients are ingesting all of their TB medications. While the benefits of DOT are clear, costs, human resources, and other barriers make DOT impractical or impossible in many settings. Video DOT (VDOT) reduces the barriers making remote patient observation feasible and cost-effective.

With DOT, healthcare workers meet with patients “in person” to watch every dose of medication being taken over the six to 24 month course of treatment. DOT has been shown to be highly effective at improving treatment adherence and health outcomes. As such, DOT is the strategy recommended by the World Health Organization and the Centers for Disease Control for treating TB.  Although effective, the DOT process can be time consuming and expensive, in addition to reducing patient autonomy and putting patients at risk for loss of confidentiality and stigma.  It can also be difficult or impossible to perform for patients who live in remote areas. 

SureAdhere's Video DOT (VDOT) system replaces daily, in-person patient visits, centralizes and simplifies DOT administration, and can reduce costs for existing DOT programs. The time savings generated by VDOT may then be used by healthcare providers to better support their patients who need help with adherence.  It also improves patient satisfaction by increasing autonomy and privacy, as well as increasing access to DOT for hard to-reach patients. 

 

Opioid Substitution Therapy

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Opioid substitution therapy (OST) aids in curbing opioid use (e.g., heroin and prescription opioids like OxyContin, Vicodin, fentanyl, etc.) by occupying the opioid receptors in the brain and reducing or blocking the effects of heroin and other opioids.

Patients enrolled in OST are able to stop using opioids and begin to rebuild their lives through counseling and pro-social activities because OST helps to reduces their cravings and feelings of withdrawal. However, in early OST treatment, patients are required by federal and state regulations to have their therapy administered by DOT. While take-home doses can be earned by trusted patients over time, the requirement for directly observed therapy places a large burden on both the patient and provider, which can make the process of recovery that much harder.

By using SureAhdere's VDOT system to remotely monitor OST, patients can be observed taking their medication at home, thereby reducing the burden of travel and allowing the patient to work, care for children and go about their daily activities. 

 

HIV PrEP

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HIV PrEP (pre-exposure prophylaxis) is a new prevention method in which people without HIV take a daily pill to reduce their risk of becoming infected.  Studies have show that PrEP can reduce the risk of HIV infection by 92%, but only when PrEP is taken as directed.

People who use PrEP must commit to taking the drug every day and seeing their health care provider for follow-up every 3 month.  While DOT is not required for patients taking PrEP, it can be help them to take their pills consistently, especially in the beginning when patients are learning to make PrEP part of their daily routine.  It can also help providers and treatment counselors develop the positive rapport with their patients that is critical to forming long-term treatment relationships.  Since SureAdhere's VDOT system allows patients to take their medications whenever and wherever they choose, patients can be observed with minimal disruption to their lives and receive all the benefits of DOT.

 

Hepatitis C

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An estimated 2.7-3.9 million people in the United States have chronic hepatitis C (CDC, 2016), and is the leading indication for liver transplants.  New highly effective treatments are now available that eliminate the hepatitis C virus so patients can be cured and will no longer be able to spread the virus to others.

Hepatitis C virus infection is treated with antiviral medications intended to clear the virus from the patient's body. The goal of treatment is to eliminate the virus from the patient so liver damage stops. Recent clinical advances have reduced treatment time to approximately three months with 95% effectiveness. However, once-daily oral medications must be taken consistently to cure the patient and avoid having the virus become resistant to the new drugs. To ensure patients have taken their daily dose of medication, DOT has been proposed by some health professionals to monitor Hepatitis C treatment adherence. SureAhdere's VDOT system accomplishes the goals of DOT with a minimum of effort for the patient and the provider.