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Laws Impacting Use of Video Direct Observed Therapy for Tuberculosis Patients

posted on Wed, Aug 20 2014 1:53 pm by Western Region

The Network recently received a request from a county public health department for information regarding video direct observed therapy (VDOT) and related law. The department is considering the practice as a way to become more efficient in caring for the tuberculosis patients.

Conventional direct observed therapy (DOT) is a medical technique in which a health care professional observes a patient taking treatment drugs every time the patient takes a dose. It is used to increase treatment adherence rates, especially in treating tuberculosis patients —according to the CDC, it is “the most effective strategy for making sure patients take their medicines.”

In VDOT, a medical professional observes the patient taking their treatment dose remotely through video technology. This can help alleviate difficulties with implementing DOT, including logistical issues, high labor and time costs, privacy concerns, and problems reaching patients in remote areas.

The Network researched laws that might impact the use of VDOT in each of the 11 states in its Western Region and produced a table summarizing the findings. For example, in Washington, Oregon and California, both participants in a VDOT session must consent if the session is to be recorded. In Utah, in contrast with other jurisdictions, VDOT may be used for certain drug regimens, but cannot be used for a 12-week drug regimen of Isoniazid and Rifapentine – only DOT may be employed. Three states —California, Oregon and Washington — affirmatively allow and encourage VDOT, whereas it is likely permissible but not affirmatively encouraged in seven of the analyzed states.

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