{"doi":"10.5588/ijtld.22.0583","title":"Challenges associated with electronic and in-person directly observed therapy during a randomized trial","abstract":"BACKGROUND: Electronic directly observed therapy (eDOT) has been proposed as an alternative to traditional in-person DOT (ipDOT) for monitoring TB treatment adherence. Information about the comparative performance and implementation of eDOT is limited. METHODS: The frequency of challenges during DOT, challenge type, and effect on medication observation were documented by DOT method during a crossover, noninferiority randomized controlled trial. A logistic mixed-effects model that adjusted for the study design was used to estimate the percentage of successfully observed doses when challenges occurred. RESULTS: A total of 20,097 medication doses were scheduled for observation with either eDOT (15,405/20,097; 76.7%) or ipDOT (4,692/20,097; 23.3%) for 213 study participants. In total, one or more challenges occurred during 17.3% (2,672/15,405) of eDOT sessions and 15.6% (730/4,692) of ipDOT sessions. Among 4,374 documented challenges, 27.3% ( n = 1,192) were characterized as technical, 65.9% ( n = 2,881) were patient-related, and 6.9% ( n = 301) were program-related. Estimated from the logistic model ( n = 6,782 doses, 173 participants), the adjusted percentage of doses successfully observed during problematic sessions was 21.7% (95% CI 11.2–37.8) for eDOT and 4.2% (95% CI 1.1–14.7) for ipDOT. CONCLUSION: Compared to ipDOT, challenges were encountered in a slightly higher percentage of eDOT sessions but were more often resolved to enable successful dose observation during problematic sessions.","journal":"The International Journal of Tuberculosis and Lung Disease","year":2023,"id":383173,"datarank":0.20452888352863746,"base_score":1.0986122886681096,"endowment":1.0986122886681096,"self_citation_contribution":0.16479184330021646,"citation_network_contribution":0.03973704022842099,"self_endowment_contribution":0.16479184330021646,"citer_contribution":0.03973704022842099,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":2,"citers_with_citation_signal":1,"citers_with_endowment":1,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9581,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT03266003"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":867241,"name":"Joseph Burzynski","orcid":"0000-0002-7109-7669","position":1,"is_corresponding":false},{"id":867245,"name":"B. Rey deCastro","orcid":"0000-0002-1610-5849","position":2,"is_corresponding":false},{"id":1150367,"name":"M. M. Salerno","orcid":null,"position":3,"is_corresponding":false},{"id":867243,"name":"Chee Kin Lam","orcid":"0000-0002-4821-4898","position":4,"is_corresponding":false},{"id":867244,"name":"Michelle Macaraig","orcid":"0000-0002-2891-9903","position":5,"is_corresponding":false},{"id":1150368,"name":"M. Reaves","orcid":null,"position":6,"is_corresponding":false},{"id":1150369,"name":"S. Kiskadden-Bechtel","orcid":null,"position":7,"is_corresponding":false},{"id":1150370,"name":"S. Bowers","orcid":null,"position":8,"is_corresponding":false},{"id":868017,"name":"Charlene Sathi","orcid":null,"position":9,"is_corresponding":false},{"id":1150371,"name":"M. P. Dias","orcid":null,"position":10,"is_corresponding":false},{"id":607693,"name":"Neela D. Goswami","orcid":"0000-0003-4508-9144","position":11,"is_corresponding":false},{"id":1150372,"name":"AndrewA. Vernon","orcid":null,"position":12,"is_corresponding":false},{"id":1150373,"name":"for the eDOT Study Team","orcid":null,"position":13,"is_corresponding":false},{"id":867242,"name":"Joan M. Mangan","orcid":"0000-0001-6770-086X","position":0,"is_corresponding":true}],"reference_count":11,"raw_metadata":null,"created_at":"2026-07-19T01:17:25.158896Z","pmid":"37035970","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}