Economic Incentives and Video Directly Observed Therapy to Promote Adherence to Latent Tuberculosis Infection

What this Trial Is About

Researchers are evaluating a new approach combining Video Directly Observed Therapy (vDOT) and financial incentives to help adults complete treatment for latent tuberculosis (TB). The study focuses on adults starting treatment for latent TB in the Baltimore area, aiming to increase treatment completion rates compared to usual care. This is an interventional trial designed to address challenges like poverty, access to care, and language barriers that often affect treatment adherence in this population. Participants will be randomly assigned to one of three groups: usual care with medication and nurse case management, Video-DOT using a smartphone app to record medication intake, or Video-DOT plus financial incentives for verified medication adherence. The Video-DOT system uses the emocha app to securely record and confirm medication ingestion, while the incentive group can earn payments based on their adherence. Medication regimens include short courses with isoniazid, rifapentine, or rifampin, and treatment lasts up to six months. During the study, participants will have their medication adherence monitored through electronic caps on medication bottles and video verification. Researchers will assess treatment completion, defined as taking at least 80% of prescribed doses, along with other adherence measures and the costs of the incentive program. Visits will include routine care, education, and toxicity assessments. The study runs for up to six months with extended cost-effectiveness follow-up for five years, ensuring careful monitoring and support throughout treatment.

Economic Incentives and vDOT for Latent Tuberculosis Infection