Patient perceptions of video directly observed therapy for tuberculosis: a systematic review.

Virtual modes of tuberculosis (TB) treatment monitoring have become increasingly relevant in the last decade with the advancements and increasing accessibility of technology. We conducted a systematic review comparing people with TB's perceptions of standard directly observed therapy (DOT) versus video directly observed therapy (vDOT). Studies were obtained from MEDLINE and EMBASE between January 1, 1974 and February 4, 2021. Of the 22 articles reviewed, a qualitative thematic analysis was performed, drawing on common themes from people with TB's perception of their care. 21 studies showed relative preference for and acceptance of vDOT over DOT. Factors that increased acceptability toward vDOT included cost and time saving, personal sense of empowerment, convenience, and privacy. Studies also showed greater adherence to treatment and subsequent improved health outcomes. vDOT has the potential to be an empowering, person-centered treatment modality for TB therapy. The role of social determinants such as place of residence, access to technology, and patient-provider communication requires further exploration.

Adult Day Program Directors' Experiences Managing the COVID-19 Pandemic.

Adult day programs (ADPs) provide community-based supervised recreational services to older adults living with chronic conditions and their caregivers. Most ADPs continued operating during the pandemic, tasking directors with the responsibility of managing the complexities of the coronavirus disease (COVID-19) pandemic. This study explored how ADP directors managed and experienced the COVID-19 pandemic. Semi-structured interviews were conducted with 18 ADP directors from a large health care region in Ontario. Thematic analysis resulted in four themes that detailed how participants: 1) responded to the pandemic with adapted services; 2) navigated the pandemic responses within systems and organizations, and with each other, clients, and caregivers; 3) felt personally during the pandemic; and 4) gained new insights on their clients and the importance of ADPs in the health care system due to the pandemic. Findings highlight pre-existing and emerging gaps and opportunities within ADP service provision for clients and caregivers, as well as service providers and directors.