Efficacy of a brief educational video for patients prescribed latent tuberculosis treatment: a randomized trial in the United States
Katia J Bruxvoort, Lei Qian, Zhouxin Li, Brigitte Spence, Sally Shaw, Heidi Fischer, Jennifer Ku, Bruno Lewin, Jacek Skarbinski, Sara Y TartofAbstract
Background
Treatment for latent tuberculosis infection (LTBI) is important for preventing tuberculosis disease, but many patients with LTBI do not complete treatment. Patients report barriers to treatment including poor knowledge of LTBI and insufficient treatment support.
Methods
We conducted a randomized trial of a 3-minute educational video for patients prescribed LTBI treatment. Adults at Kaiser Permanente Southern California prescribed LTBI treatment were randomized to receive messages with the video link (intervention) or no intervention (control). Patients were followed for up to 12 months to assess treatment initiation and completion. We also conducted a brief survey among patients who watched the video and convened a focus group among those who did not.
Results
During 06/2022-12/2023, we enrolled 496 patients in the control group and 1398 patients in the intervention group, of whom 17.0% watched the video. Patient characteristics were balanced between groups. Most were prescribed rifampin (64.8%) and isoniazid (23.4%). In intention-to-treat analyses, 82.9% and 78.8% of patients in control and intervention groups, respectively, initiated treatment (RR 0.95 [95% CI: 0.90-1.00]) and 41.5% and 40.1% completed treatment (RR 0.97 [0.85-1.09]). In per-protocol analyses, 83.1% and 86.5% initiated treatment (aRR 1.03 [0.96-1.11]) and 41.4% and 45.1% completed treatment (aRR 1.06 [0.88-1.27]). Patients reported high acceptability and few challenges watching the video. Message fatigue and non-specific messages were reasons for not watching the video.
Conclusion
The LTBI video intervention was not associated with increased treatment initiation and completion in this study. Additional interventions are needed to improve patient knowledge and support LTBI treatment.