Community pharmacists-led interventions in tuberculosis care: A systematic review

Wong, Yen Jun; Ng, Khuen Yen; Lee, Shaun Wen Huey

doi:10.1016/j.sapharm.2022.09.001

Cited by 4 publications

(11 citation statements)

References 26 publications

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“…Participants in this study believed that community pharmacy-based DOTS programme could further expand their professional role in primary care. For example, a recent review reported that community pharmacists have the potential to improve TB outcomes with their role in TB screening, referrals, and TB-DOT (Wong et al, 2022). While the Malaysia National TB Control Strategy Plan 2015 to 2022 indicated the importance of PPM in tackling TB, the role of community pharmacists was not explicitly outlined in the strategy plan (Ministry of Health Malaysia, 2016).…”

Section: Discussionmentioning

confidence: 99%

“…For example, the private practitioners in India, Indonesia, Bangladesh, and the Philippines had contributed to TB management in the primary care settings (Lei et al, 2015;Malmborg et al, 2011). In addition, evidence has also shown the implementation of TB-PPM in several low-middle income countries (LMICs), namely Cambodia, Myanmar, and Vietnam had strengthened the collaboration between the public and private sectors in facilitating the referral, TB screening, and diagnosis (Bell et al, 2015;Lonnroth et al, 2003;Mihalea and Richardson, 2011;Thu, 2015;Wong et al, 2022;Zawahir et al, 2021). However, community pharmacists, as healthcare providers from the private sector, are underutilized in the delivery of TB service, in particular TB-DOT (Konduri et al, 2017;Lei et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

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Engaging community pharmacists in tuberculosis-directly observed treatment: a mixed-methods study

Wong

Thum

et al. 2023

Prim Health Care Res Dev

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Aim: This study aimed to evaluate the feasibility of implementing community pharmacy-based tuberculosis-directly observed treatment (TB-DOT) in Malaysia. Background: Tuberculosis (TB) eradication is one of the top priorities in the public health agenda in Malaysia. While public-private mix (PPM) initiatives have been launched, community pharmacists remain undervalued assets in TB management. Methods: A two-phase mixed-methods study targeting community pharmacists was conducted in Malaysia between March and October 2021. The first phase was an online self-administered survey developed according to the Consolidated Framework for Implementation Research (CFIR). The second phase was a semi-structured interview to allow deeper understanding on the quantitative results. Quantitative data were analysed using descriptive analysis while qualitative data were analysed using thematic analysis with a semi-inductive approach. The data were triangulated to enhance comprehensiveness and credibility of the findings. Findings: The survey was completed by 388 community pharmacists, and 23 pharmacists participated in the interview. Most community pharmacists indicated their willingness to serve as TB-DOT supervisors (70.1%). Qualitative results supported the findings. Community pharmacy-based TB-DOT service was perceived as an avenue to improve TB management and outcomes and to enhance the professional role of pharmacists in TB service at primary care settings. This was also perceived as a feasible intervention with the potential to strengthen the National TB Control programme. This initiative needs be reinforced with adequate support from the public healthcare sector for a strong partnership in ensuring success.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Engaging community pharmacists in tuberculosis-directly observed treatment: a mixed-methods study

Wong

Thum

et al. 2023

Prim Health Care Res Dev

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“…Non-adherence to treatment is a significant factor causing inadequate drug effectiveness and adverse reactions, leading to drug resistance 24 25. Pharmacist intervention through CPS can address these issues,25–28 but its implementation is challenging18 and requires a comprehensive and collaborative approach focusing on the unique traits of each patient 2 7…”

Section: Discussionmentioning

confidence: 99%

Multidisciplinary tuberculosis care: leveraging the role of hospital pharmacists

Iskandar,

Pradipta,

Anggriani

et al. 2023

BMJ Open Resp Res

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IntroductionOptimal pharmacological treatment of tuberculosis (TB) requires a multidisciplinary team, yet the hospital pharmacist’s role is unclear. We aimed to analyse hospital pharmacist-provided clinical pharmacy services (CPS) implementation in TB care.MethodA nationwide survey-based online cross-sectional study was conducted on hospital pharmacists in Indonesia from 1 November 2022 to 22 November 2022. Outcomes were the extent of pharmacists’ involvement in multidisciplinary TB care, TB-related CPS provided and views on TB-related CPS. The probability of pharmacists’ involvement in multidisciplinary TB teams was assessed using logistic regression.ResultsIn total, 439 pharmacists (mean age 31.2±6.22 years, 78% female) completed the survey. Thirty-six per cent were part of multidisciplinary TB care, and 23% had TB-related tasks. Adherence monitoring (90%) and drug use evaluation (86%) were the most conducted TB-related CPS. Pharmacists’ views on TB-related CPS implementation were generally positive, except for financial incentives. Work experience (OR 1.99, 95% CI 1.09 to 3.61), ever received TB-related training (OR 3.51, 95% CI 2.03 to 6.14) and specific assignments to provide TB-related CPS (OR 8.42, 95% CI 4.99 to 14.59) significantly increased pharmacist involvement in multidisciplinary TB care.ConclusionAround one-third of hospital pharmacists are part of multidisciplinary TB care, with medication adherence and drug use monitoring as primary tasks. Pharmacists’ experience, training, assignment to provide TB-related CPS and financial incentives are key elements for further implementation in multidisciplinary TB care. Pharmacists should proactively support current TB care and conduct operational research, sharing data with healthcare peers and fostering a collaborative multidisciplinary TB care team.

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“…In fact, pharmacists can see their patients 10 times more than other healthcare providers (Tsuyuki et al, 2018 ). Pharmacists have a unique opportunity to detect TB by identifying symptomatic patients and referring them for TB screening (Pradipta et al, 2023 ; Wong et al, 2023 ). Pharmacist involvement in TB programmes can improve continuity of care and bridge the gap between symptoms detection and monitoring of treatment (Wong et al, 2023 ).…”

Section: Introductionmentioning

confidence: 99%

“…Pharmacists have a unique opportunity to detect TB by identifying symptomatic patients and referring them for TB screening (Pradipta et al, 2023 ; Wong et al, 2023 ). Pharmacist involvement in TB programmes can improve continuity of care and bridge the gap between symptoms detection and monitoring of treatment (Wong et al, 2023 ). In addition, they play a crucial role in optimising therapy of patients after TB diagnosis, ensuring that appropriate patient-centred care is given, and minimising anti-TB drugs-related adverse effects (Iskandar et al, 2023 ; Miller & Goodman, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Impact of pharmaceutical care interventions in improving clinical outcomes among patients with pulmonary tuberculosis: a systematic review

Awad,

Jaam,

Awaisu

et al. 2024

Journal of Pharmaceutical Policy and Practice

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Background Pharmacists can play an important role in the fight against tuberculosis (TB) through optimising medication use and safety, promoting adherence to anti-TB drugs, and providing patient education. Limited evidence is available on the effectiveness of pharmacist’s interventions on health outcomes in patients with pulmonary TB. This systematic review aims to assess the effectiveness of pharmaceutical care interventions in the management of pulmonary TB. Methods English language studies assessing the impact of pharmaceutical care interventions in TB management were searched across three electronic databases (PubMed, Embase, Cochrane), a RCT registry ClinicalTrial.gov, a peer-reviewed journal ‘The Lancet Infectious Diseases’, and the references of retrieved articles. Interventions delivered by pharmacists alone or as part of multidisciplinary teams were included in the review. Data were extracted using the modified Cochrane EPOC standardised data collection tool. The Cochrane Risk of Bias 2 and the NIH quality assessment tools were used to assess the risk of bias among included studies. Data were synthesised narratively. (PROSPERO Protocol Registration CRD42022325771). Results Thirteen studies, including two randomised controlled trials (RCTs) with a total of 3886 patients were included. Many of the included studies had a high risk of bias and lacked cohert reporting of treatment outcomes. The most common pharmaceutical care interventions were education and counselling regarding adverse drug reactions and resolution of drug-related problems. Five studies showed a relatively high TB completion rate yet only one study reached the targeted treatment success goal of (>90%). Conclusion The current evidence suggests that pharmaceutical care interventions can potentially improve treatment outcomes among patients with pulmonary TB. However, no definitive conclusion can be drawn given the low methodological quality of the included studies and lack of long-term follow-up data. Well-designed RCTs with careful attention to study methodology, standardised outcomes assessment aligned with the World Health Organization’s guidelines are warranted to guide future practice and policy.

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Community pharmacists-led interventions in tuberculosis care: A systematic review

Cited by 4 publications

References 26 publications

Engaging community pharmacists in tuberculosis-directly observed treatment: a mixed-methods study

Engaging community pharmacists in tuberculosis-directly observed treatment: a mixed-methods study

Multidisciplinary tuberculosis care: leveraging the role of hospital pharmacists

Impact of pharmaceutical care interventions in improving clinical outcomes among patients with pulmonary tuberculosis: a systematic review

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