Recommendations for Use of Video Directly Observed Therapy During Tuberculosis Treatment

United States, 2023

Joan M. Mangan, PhD; Rachel S. Woodruff, MPH; Carla A. Winston, PhD; Scott A. Nabity, MD; Maryam B. Haddad, PhD; Meredith G. Dixon, MD; Farah M. Parvez, MD; Carissa Sera-Josef, MS; LaTweika A. T. Salmon-Trejo, MPH; Chee Kin Lam, MS, MPH


Morbidity and Mortality Weekly Report. 2023;72(12):313-316. 

In This Article

Abstract and Introduction


U.S. clinical practice guidelines recommend directly observed therapy (DOT) as the standard of care for tuberculosis (TB) treatment.[1] DOT, during which a health care worker observes a patient ingesting the TB medications, has typically been conducted in person. Video DOT (vDOT) uses video-enabled devices to facilitate remote interactions between patients and health care workers to promote medication adherence and clinical monitoring. Published systematic reviews, a published meta-analysis, and a literature search through 2022 demonstrate that vDOT is associated with a higher proportion of medication doses being observed and similar proportions of cases with treatment completion and microbiologic resolution when compared with in-person DOT.[2–5] Based on this evidence, CDC has updated the recommendation for DOT during TB treatment to include vDOT as an equivalent alternative to in-person DOT. vDOT can assist health department TB programs meet the U.S. standard of care for patients undergoing TB treatment, while using resources efficiently.