Factors Influencing Video Directly Observed

Therapy Adoption in Malaysia

Funnel method of writing introduction

1. Introduction
Despite increased global awareness and diagnostic efforts, tuberculosis continues to be a
significant cause of death from infectious disease, even though only a few kinds of
tuberculosis are curable (Baya et al., 2019; Subbaraman et al., 2018). After the Human
Immunodeficiency Virus (HIV), in adults, tuberculosis is the second highest cause of
mortality (Atif et al., 2014). Globally, approximately 11 million new cases of tuberculosis
occur each year. Each year, over two million people die from active tuberculosis (Baya et al.,
2018; Subbaraman et al., 2018; Tok et al., 2020). By 2020, it was anticipated that the
global tuberculosis epidemic would exceed a billion people. The goal was to achieve a 35%
decrease in active patient numbers (Atif et al., 2014). Before the COVID-19 pandemic,
nearly 4000 people perished each day from tuberculosis (McQuaid et al., 2020; WHO,
2019). The impact of this public health emergency on tuberculosis is unknown and Overvie
consequently remains a matter of apprehension (Wingfield et al., 2020). This has not been w-
thoroughly addressed in a recent study (Glaziou, 2020). It is currently uncertain if the social Global
distance can compensate for tuberculosis care delivery disruptions or the likely impact of
these combined COVID-19 disruptions on the tuberculosis burden (McQuaid et al., 2020).
The COVID-19 public health emergency is impacting the treatment of other diseases. This
epidemic poses a threat to meeting the tuberculosis objective on time. By 2035, the World
Health Organization (WHO) hopes to have reduced tuberculosis-related mortality by 95%
and tuberculosis incidence by 90%. Thus, effective patient management programs should be
devised to accomplish this objective, which is necessary to benefit both patients and the
community (Uplekar et al., 2015). A novel or improved way of treating tuberculosis must be
considered and analyzed to achieve the worldwide target strategy of tuberculosis elimination
(The World Bank, 2017).
Tuberculosis is still regarded as one of the five most infectious illnesses in Malaysia. As a
result, tuberculosis outbreaks continue to pose a severe challenge to the countries' healthcare
systems. The success rate of pulmonary tuberculosis treatment is 85 percent (Atif et al.,
2014). Due to the contagious nature of the disease, notably pulmonary tuberculosis, treatment
and prevention are as challenging for the healthcare system as they are dangerous for public
health (Subbaraman et al., 2018). A variety of tuberculosis infections require roughly 180
days of daily therapy (Do et al., 2019; Johnston, Campbell & Menzies, 2017). Tuberculosis
patients in Malaysia visit healthcare facilities daily, or a skilled healthcare service provider
visits patients' homes to verify medication compliance. This treatment technique is referred to
as Direct Observation of Therapy (DOT) (The World Bank, 2017; Story et al., 2016).
Although the DOT's direct supervision strategy enhances compliance, it does have significant
drawbacks (Lutge et al., 2015). DOT practice is inconvenient for patients and exposes them
to risks from others, as the pulmonary tuberculosis virus can spread via the air. It entails
aligning the patient's schedule and location with the DOT service provider's routine
medication. These barriers prompted the development of mHealth interference dubbed Video
Directly Observed Therapy (VDOT) as a means of circumventing such barriers in lieu of
DOT adherence (Garfein et al., 2015). The WHO (2015) recommended using
communication technology in healthcare settings, and VDOT can treat tuberculosis patients
via mobile phone applications. mHealth (mobile health) is successfully aiding in the
cessation of smoking (Finkelstein & Cha, 2016; McClure, Hartzler, & Catz, 2016),
postoperative care and diabetic patients’ self-management , among other things (Scott et al.,
2017; Wu et al., 2017). The VDOT mHealth approach can reduce tuberculosis exposure in
the general community without interfering with patients' daily lives. In some high-income
countries, the feasibility analysis has revealed favorable research outcomes for VDOT
mHealth (Eshet, Reuver & Bouwman, 2017; WHO, 2015).
VDOT is a drug administration a surveillance technique for capturing and transmitting
digital photographs of patients' medication ingestion to a allocated site for caregivers
reference. A patient records footage using a smartphone application with a date and time
stamp during medicine consumption and then shares it with a healthcare service provider.
The clinical supervisor can then monitor and record each dose administered to the patient
(WHO, 2015). VDOT enables two distinct strategies. One is real-time, while the other is
patient–recorded video sharing. As a result, a simple monitoring strategy for tuberculosis
patients provides flexibility for both parties (Eshet, Reuver & Bouwman, 2017; WHO,
2015). VDOT serves as a daily reminder to take medications. Patients can contact their
clinical supervisor throughout therapy using mobile phone messaging, emailing, and calling
capabilities (WHO,2015). Research has also been conducted on designing features in the Research
VDOT to support distress and loneliness, emotional states that tuberculosis patients always gap
experience during their treatment (Khalid & Ghazali, 2019). However, A modest number
of study has been done to ascertain users' intentions about the use of VDOT services. The Aim &
purpose of this study is to create an awareness of patients' convenience when using mobile Objective
health applications in order to aid in the design and development of the VDOT app. The
goal of this research is to ascertain the parameters influencing the VDOT adoption among
the general population in peninsular Malaysia.

In a proposal, research gap, aim, objective, question is a part of Chapter 2, Literature Review.

Source:
Hira, F. A., Khalid, H., Shashikala, A., & Moshiul, A. M. (2022). Factors of Video Directly
Observed Therapy Adoption in Malaysia. International Journal of Academic Research in
Business and Social Sciences, 12(1), 971–982.