New technology that could allow healthcare workers to remotely monitor whether their patients are adhering to their TB medication was recently unveiled at the 48th Union World Conference on Lung Health in Mexico.
According to data presented at the conference, the new technology, called Wirelessly Observed Therapy (WOT), is more effective than the current gold standard for ensuring treatment adherence – Directly Observed Therapy (DOT), and has the potential to transform TB treatment adherence.
DOT involves diagnosis by sputum-smear microscopy and medication given under direct observation and supervision by healthcare workers to ensure drugs are taken at the right time. However it’s resource intensive and expensive, making its implementation in low-resource settings difficult.
“WOT has the potential to treat tens of thousands of people more effectively which means more people cured and less people developing multidrug-resistance – a real game changer,” said Executive Director of The Union, the organiser of the conference, José Luis Castro.
TB is now the world’s leading cause of death from an infectious disease (1.8 million deaths annually), having surpassed HIV/AIDS in 2015, and is increasingly characterised by drug resistant forms of the disease. According to Castro, it’s new technologies in the diagnosis and treatment of TB that are going to be key to eliminating TB by 2030.
The FDA-approved WOT device consists of an edible ingestion sensor and an external wearable patch which, when paired with a mobile device, can detect and record when patients take their medicine.
Patients swallow an ingestible sensor made of minerals found in food which breaks down in the body, releasing a sensor the size of a grain of sand that sends data to a patch worn on the patient’s chest. The patch stores the data until it comes into contact with a mobile device – a tablet or any mobile phone with Bluetooth capacity. The mobile device encrypts the data and sends it via wireless Internet to the patients’ healthcare provider.
“WOT confirmed over 50% more doses than DOT. DOT is only available during business hours, so patients get no support at weekends or holidays and no data are gathered,” said Associate Professor of Clinical Medicine at the University of California, San Diego who did the study, Dr Sara Browne.
“WOT doesn’t require a lot of personnel and can cover large distances. If it is appropriately implemented, there is no limit to the number of patients you can observe with WOT. And this method creates an immediately digitised record – healthcare providers have instant access to digital summaries of all their patients’ data for analysis,” continued Dr Browne.
According to Devex, Dr Browne is now working with experts to analyse the global cost of rolling out such a device and is hoping to begin larger clinical trials in South Africa soon. SA has one of the highest burdens of TB in the world, with an estimated incidence of 454,000 cases of active TB in 2015.