Practical Models of Pharmaceutical Care for Improving Tuberculosis Patient Detection and Treatment Outcomes: A Systematic Scoping Review

Abstract

Decreasing global tuberculosis (TB) notifications indicate problems related to TB patient detection and treatment outcomes. Pharmaceutical care (PC) has potential roles in managing these issues. However, PC practices have not yet become widespread in the real world. This systematic scoping review aimed to identify and analyze the current literature on practical models of pharmaceutical care for improving tuberculosis patient detection and treatment outcomes. We then discussed the present challenges and future considerations for the successful implementation of PC services in TB. A systematic scoping review was performed to identify the practice models of PC in TB. Systematic searches and screening were used to identify relevant articles in the PubMed and Cochrane databases. We then discussed the challenges and recommendations for successful implementation using a framework to improve professional healthcare practice. Our analysis included 14 of 201 eligible articles. We identified that the focuses in the PC of TB are on increasing patient detection (four articles) and improving TB treatment outcomes (ten articles). Practices cover services in the community and hospital settings, such as screening and referring people with presumptive TB, tuberculin test services, collaborative practices for treatment completion, directly observed treatment, the solution of drug-related problems, reporting and managing adverse drug reactions, and medication adherence programs. Although PC services positively increase TB patient detection and treatment outcomes, hidden challenges in the actual practice are analyzed. Several factors should be comprehensively considered in successful implementation, such as guidelines, individual pharmacy personnel, patient, professional interaction, organizational capacity, regulation, incentive, and resource factors. Hence, a collaborative PC program that involves all related stakeholders should be considered to create successful and sustainable PC services in TB.

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

“…However, only two studies used this strategy besides the pharmacists’ services provided (Jakeman et al, 2020 ; Juan et al, 2006 ). The provision of DOT by pharmacists is a cornerstone in TB control efforts (Pradipta et al, 2023 ). This service is particularly essential for patients with latent TB infection and those who may face challenges in adhering to their treatment regimens independently.…”

“…This omission posed challenges in assessing the practicality and sustainability of the interventions provided by pharmacists. In fact one systematic review highlighted that incentives are of great importance to ensure continuity of service provision (Pradipta et al, 2023 ).…”

“…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 ).…”

Pharmacy engagement in TB prevention and care: not if, but how?

“…The dialogue must shift towards how to engage pharmacies more effectively and address the bottlenecks. 15 Here, we propose three priority actions that should be taken, especially in high-burden settings:…”