Impact Of Pharmacist Counselling On Knowledge, And Medication Adherence In Tuberculosis Patients: A Quasi-Experimental Design

Abstract

Medication adherence and knowledge towards tuberculosis management are very important to cure and to prevent resistant tuberculosis. The study aims to evaluate the impact of pharmacist delivered counseling services on knowledge and medication adherence levels of tuberculosis patients. This is a quasi-experimental design without control conducted in an infectious unit of a secondary care referral hospital located in rural settings of Anantapur district, India. The study protocol was approved by the institutional review board. A suitable data collection form was used to collect the knowledge and medication adherence levels of the study participants, A total of 258 smear positive pulmonary tuberculosis patients were recruited in the study. More than half of the participants belonged to male gender with a mean age of 48.1±15.3years. Majority of the participants had smoking and alcohol consumption habits (30.6%), coolie as occupation (37.9%), and no formal education (36.4%). The mean knowledge score was significantly improved from baseline to first follow-up, and first follow-up to second follow-up, and baseline to second follow-up visits with a P <0.05. There was a significant difference in the medication adherence levels measured by pill-count method at baseline, 1 st follow-up, and 2 nd follow-up visits with P <0.05. The study concludes that pharmacist mediated counseling in tuberculosis patient showed a significant improvement in knowledge and medication adherence levels from baseline to 1 st and 2 nd follow-up visits. Knowledge regarding causes, mode of transmission, symptoms, management and prevention of tuberculosis are most important to minimize spread of infection and drug resistance.

Clinical pharmacy services for tuberculosis management: a systematic review

“…Table 1 provides an overview of the included studies. Six studies originated from high-TB-burden countries, including four from India (Bhardwaja et al, 2012;Venkatapraveen et al, 2012;Thomas et al, 2018;Narayana et al, 2020), one from China (Tang et al, 2018), and one from Indonesia (Karuniawati et al, 2019). Others were from different regions: Thailand (Tanvejsilp et al, 2018), Ivory Coast (Abrogoua et al, 2016), Türkiye (Clark et al, 2007), andBrazil (Lopes et al, 2017).…”

“…Notably, among the 10 studies, no randomized controlled studies were identified. Study designs were heterogeneous and included five prospective cohort studies (50%) (Bhardwaja et al, 2012;Venkatapraveen et al, 2012;Lopes et al, 2017;Tanvejsilp et al, 2018;Thomas et al, 2018), two case-control studies (20%) (Clark et al, 2007;Tang et al, 2018), two quasi-experimental studies (with and without control) (Karuniawati et al, 2019;Narayana et al, 2020), and a cross-sectional study (Abrogoua et al, 2016). Most studies were prospective; for only one study, this was unknown (Abrogoua et al, 2016).…”

“…Most studies were prospective; for only one study, this was unknown (Abrogoua et al, 2016). Most study settings were in the tertiary care hospital, except for one, which was in a secondary care hospital (Narayana et al, 2020). The study duration ranged from 5 to 35 months, and patient numbers varied between 39 and 258.…”

“…Of the 10 studies included in the review, clinical data sources used for clinical pharmacy services were varied; seven studies used adherence measuring tools (70%) (Clark et al, 2007;Bhardwaja et al, 2012;Venkatapraveen et al, 2012;Tang et al, 2018;Thomas et al, 2018;Karuniawati et al, 2019;Narayana et al, 2020), six used medical records (60%) (Clark et al, 2007;Bhardwaja et al, 2012;Abrogoua et al, 2016;Tang et al, 2018;Tanvejsilp et al, 2018;Thomas et al, 2018), five used patient interviews (50%) (Clark et al, 2007;Bhardwaja et al, 2012;Lopes et al, 2017;Tanvejsilp et al, 2018;Thomas et al, 2018), and four used laboratory testing/ therapeutic drug monitoring (40%) (Clark et al, 2007;Venkatapraveen et al, 2012;Tang et al, 2018;Thomas et al, 2018), amongst others. The intervention focus provided within the clinical pharmacy services was medication adherence, defined as the voluntary cooperation of the patient in taking the drugs or medicine as prescribed (DEPICT, 2013), in five studies (50%) (Clark et al, 2007;Bhardwaja et al, 2012;Tang et al, 2018;Thomas et al, 2018;Karuniawati et al, 2019); medication safety in four studies (40%) (Clark et al, 2007;Abrogoua et al, 2016;Lopes et al, 2017;Tang et al, 2018); education of patients/caregivers regarding the needs/beliefs in three studies (30%) (Venkatapraveen et al, 2012;Thomas et al, 2018;Narayana et al, 2020...…”

Effect of Counselling on Medication Adherence in Tb Patients with the DOTS Strategy: A Scoping Review

“…Usual care (Goruntla et al, 2020) Patients are given counseling with education regarding the etiology, signs and symptoms, modes of transmission, and complications of tuberculosis. Patients were also educated about antitubercular therapy, duration, possible side effects, and the importance of medication adherence using brochures.…”