Integrating Digital Adherence Tools in TB Care: Comparing GRVOTS with Standard DOT in Malaysia

Abstract

Tuberculosis (TB) remains a significant global health challenge, with Malaysia experiencing persistent mortality despite declining incidence rates. This study aimed to assess treatment adherence among patients with pulmonary TB (PTB) diagnosed and managed using traditional Direct-Observed Therapy (DOT) and Gamified-Reality-Video-Observed Therapy (GRVOTS) in public healthcare facilities. A cross-sectional study was conducted in five health clinics in Selangor and Negeri Sembilan, Malaysia. The participants included 142 patients with PTB aged between 18 and 64 years, matched by age and capable of smartphone use, with data sourced from the Tuberculosis Information System (TBIS) and an existing GRVOTS research team. Sociodemographic and treatment adherence data were analyzed using descriptive statistical methods using IBM SPSS software version 28.0. Approximately 90.1% of patients in the GRVOTS group completed treatment compared with 83.3% in the DOT group, indicating significantly higher adherence to GRVOTS. Facility characteristics varied widely, from large urban clinics with robust digital infrastructure to smaller clinics with limited resources, highlighting the adaptability of GRVOTS across diverse settings. Overall, GRVOTS demonstrates potential as an effective and scalable adjunct to traditional TB treatment supervision, enhancing adherence and continuity of care across various healthcare settings. Thus, digital tuberculosis (TB) adherence solutions should match clinic capacity and patient demographics. Large clinics should implement comprehensive digital tools, whereas smaller facilities require simpler versions.