Experiencia con teléfonos móviles en el tratamiento directamente observado en TB y en otras infecciones

krios@emocha.com | @emochaHealth | www.emocha.com

Katrina Rios, Director of Strategic Partnerships

Historia basada en la investigación

TB

HCV

OSTInventado

Autorizado

TDO por vídeo

Proveedores utilizan la plataforma de emocha para revisar videos, evaluar efectos

secundarios y comprometerse con los pacientes a seguir las normas de TDO.

Pacientes utilizan una aplicación de teléfono móvil para grabar un vídeo tomando los medicamentos y para comunicar si presentan síntomas o

efectos secundarios.

Como funciona

El paciente abre la aplicación

Como funciona

Selecciona si presenta síntomas o efectos secundarios

Como funciona

Graba un vídeo tomando los medicamentos

Como funciona

Recibe comentarios alentadores

Como funciona

Sigue el progreso a través de un calendario de adherencia

Como funciona

TDO por vídeo

Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America Clinical Practice Guidelines: Treatment of Drug-Susceptible Tuberculosis, Clinical Infectious Diseases, Volume 63, Issue 7, 1 October 2016, Pages e147–e195, https://doi.org/10.1093/cid/ciw376

Handbook for the use of digital technologies to support tuberculosis medication adherence. Geneva: World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO.

“In recent years, DOT has expanded to other modalities such as web-based video and mobile phones, which have been well

received by both patients and health department staff”

TDO por vídeo optimiza los recursos

Prado J, Vue G, Hernandez M. Use of asynchronous video directly observed therapy to improve the patient treatment experience and reduce greenhouse emissions. Independent program evaluation, January 2018.

TDO por vídeo optimiza los recursos

Samuel B Holzman, Avi Zenilman, Maunank Shah; Advancing Patient-Centered Care in Tuberculosis Management: A Mixed Methods Appraisal of Video Directly Observed Therapy (vDOT), Open Forum Infectious Diseases, , ofy046, https://doi.org/10.1093/ofid/ofy046

Pacientes“I'm about to start a class, and the class … doesn't really match the time that I have to be here to take the pill … I won't be able to do the class, and I need the class more than I need [DOT].”

“When I was in Peru for two months the system worked perfectly. Sometimes I even used it outside of the city or at the beach”

“With [vDOT] we can control [the] setting we are in … it's in your hand … just avoid taking videos in places where you can be viewed by others … we have control.”

Proveedores “Especially for people who have to get up very early in the morning to go to work. [vDOT] saves us from having to ... be at their house at 5:00am.

“I don't have to spend two hours, three hours in the morning driving all over and around the county. It frees me up time-wise enormously. I can see more patients in my office”

7x dosis diarias son recomendadas y vastamente superiores en comparación a 3x dosis semanales o dosis intermitentes

Gopalan N, Santhanakrishnan RK, Palaniappan AN, et al. Daily vs Intermittent Antituberculosis Therapy for Pulmonary Tuberculosis in Patients With HIV: A Randomized Clinical Trial. JAMA Intern Med. Published online March 05, 2018. doi:10.1001/jamainternmed.2018.0141

Tracción nacional y experiencia global

Estudio de caso | Puerto Rico

Estudio de caso: Puerto Rico

Estudio de caso: Puerto Rico

Estudio de caso: Puerto Rico

Estudio de caso: Puerto Rico

Estudio de caso: Puerto Rico

Octubre 2016 – Febrero 2017

Estudio de caso: Puerto Rico

100% Tratamiento Completado

10-25+% Cambio de Peso

200+ hrs Tiempo de Viaje Recuperado

575 Dosis Observadas

85—96% Adherencia

Publicación en CDC MMWR

TDO por vídeo en otras enfermedades infecciosas

Hepatitis C Virus

HIV & PrEP

Opioid Use Disorder

8-city RCT 3-city Implementation 2-city RCTMontefiore Medical Center - New York City, NY

Johns Hopkins University - Baltimore, MD

Harvard University - Boston, MA

Brown University - Providence, RI

UC San Francisco - San Francisco, CA

University of Washington - Seattle, WA

West Virginia University - Morgantown, WV

University of New Mexico - Albuquerque, NM

Johns Hopkins University - Baltimore, MD

Treatment Research Institute - Philadelphia, PA

Children’s National Medical Center - Washington, DC

University of Washington - Seattle, WA

Boston Medical Center - Boston, MA

Somos mas que… - Programas de TB- Agentes Comunitarios de Salud- Pacientes- Proveedores- Enfermeras

Somos una comunidad dedicada aponerle fin a la TB.

Muchas gracias!

krios@emocha.com | @emochaHealth | www.emocha.com

Katrina Rios, Director of Strategic Partnerships