Role of pharmaceutical care for self-administered pulmonary tuberculosis treatment in Thailand

Tanvejsilp, Pimwara; Pullenayegum, Eleanor; Loeb, Mark; Dushoff, Jonathan; Xie, Feng

doi:10.1111/jcpt.12519

Cited by 6 publications

(25 citation statements)

References 18 publications

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“…We identified nine studies with outcome orientations of improving TB treatment outcomes [ 14 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ]. Of these, four focused on community pharmacy services and five on hospital services.…”

Section: Resultsmentioning

confidence: 99%

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

Pradipta,

Yanuar,

Nurhijriah

et al. 2023

TropicalMed

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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.

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Section: Resultsmentioning

confidence: 99%

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

Pradipta,

Yanuar,

Nurhijriah

et al. 2023

TropicalMed

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“…Our previous study has shown that TB treatment success rates for pharmaceutical care are very similar to those for home visit or modified DOT [ 7 ]. This cost analysis shows that the pharmaceutical care approach is a relatively simple strategy that requires less healthcare resources and costs compared with the other two approaches.…”

Section: Discussionmentioning

confidence: 99%

“…This research was a part of a retrospective cohort study in which the result on the comparative effectiveness of pharmaceutical care versus to home visit and modified DOT was previously publish in the Journal of Clinical Pharmacy and Therapeutics [ 7 ], whereas this study focused on health care resource uses and costs associated to those three different strategies. The material regarding study participants was reproduced from the published article [ 7 ] with permission from the copyright owner (John Wiley and Sons).…”

Section: Transparency Declarationmentioning

confidence: 99%

“…According to our previous retrospective cohort study [ 7 ], all three TB treatment adherence enhancement strategies that are currently adopted in Thai referral hospitals provided very similar TB treatment success rates and were associated with high rates of success and exceeded the WHO treatment success target of 85%. However, there is little evidence on the economic implications associated with these strategies.…”

Section: Introductionmentioning

confidence: 99%

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Healthcare Resource Uses and Out-of-Pocket Expenses Associated with Pulmonary TB Treatment in Thailand

Tanvejsilp

Loeb

Dushoff

et al. 2017

PharmacoEconomics Open

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BackgroundIn Thailand, pharmaceutical care has been recently introduced to a tertiary hospital as an approach to improve adherence to tuberculosis (TB) treatment in addition to home visit and modified directly observed therapy (DOT). However, the economic impact of pharmaceutical care is not known.ObjectiveThe aim of this study was to estimate healthcare resource uses and costs associated with pharmaceutical care compared with home visit and modified DOT in pulmonary TB patients in Thailand from a healthcare sector perspective inclusive of out-of-pocket expenditures.MethodsWe conducted a retrospective study using data abstracted from the hospital billing database associated with pulmonary TB patients who began treatment between 2010 and 2013 in three hospitals in Thailand. We used generalized linear models to compare the costs by accounting for baseline characteristics. All costs were converted to international dollars (Intl$)ResultsThe mean direct healthcare costs to the public payer were $519.96 (95%confidence interval [CI] 437.31–625.58) associated with pharmaceutical care, $1020.39 (95% CI 911.13–1154.11) for home visit, and $887.79 (95% CI 824.28–955.91) for modified DOT. The mean costs to patients were $175.45 (95% CI 130.26–230.48) for those receiving pharmaceutical care, $53.77 (95% CI 33.25–79.44) for home visit, and $49.33 (95% CI 34.03–69.30) for modified DOT. After adjustment for baseline characteristics, pharmaceutical care was associated with lower total direct costs compared with home visit (−$354.95; 95% CI −285.67 to −424.23) and modified DOT (−$264.61; 95% CI −198.76 to −330.46).ConclusionAfter adjustment for baseline characteristics, pharmaceutical care was associated with lower direct costs compared with home visit and modified DOT.Electronic supplementary materialThe online version of this article (doi:10.1007/s41669-017-0053-0) contains supplementary material, which is available to authorized users.

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“…Pharmaceutical care provides pharmacist-led patient education at every outpatient visit, home visit provide regular home visit until treatment completion, and SAT is an approach where patients take medications by themselves at home without any additional supportive approach (see Online Appendix Table 1 for a description of these strategies). The treatment regimen was described in our previous retrospective cohort study [ 18 , 19 ].…”

Section: Methodsmentioning

confidence: 99%

Out-of-Pocket Expenditures, Indirect Costs and Health-Related Quality of Life of Patients with Pulmonary Tuberculosis in Thailand

Tanvejsilp

Loeb

Dushoff

et al. 2017

PharmacoEconomics Open

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BackgroundThailand’s hospitals may adopt different supervision approaches to improve tuberculosis (TB) treatment adherence.ObjectiveThe aim of this study was to compare out-of-pocket (OOP) expenditures, indirect costs, and health-related quality of life (HRQoL) among TB patients who received pharmaceutical care (pharmacist-led patient education and telephone consultation), home visit, and self-administered therapy (SAT) in Thailand.MethodsWe conducted a prospective study to collect OOP expenditures, indirect costs, and HRQoL from a subsample of 104 adult pulmonary TB patients who started treatment between January and May 2014 in three hospitals. The three sources of data included patient interviews, patient medical records, and the hospital billing database. Patients were followed from January 2014 to March 2015. Relevant OOP expenditures collected during the interviews included (1) healthcare costs and other medications costs (e.g. vitamins, antibiotics, anti-cough) occurring in private healthcare units; and (2) costs of transportation, food, and accommodation. Productivity loss was measured using the self-reported amount of time a patient was unable to work due to TB, travel time to and from the hospital, time spent at the hospital (waiting time, consultation time, and hospitalizations), and time spent accompanying family members on outpatient visits or during hospitalizations. Cost differences among treatment strategies were adjusted for baseline characteristics by generalized linear models (GLMs). All costs were converted to international dollars (I$).ResultsA total of 256 eligible patients who started pulmonary TB treatment during the specified period were approached, with 104 patients being included in the analysis (29, 38, and 37 patients receiving pharmaceutical care, home visit, and SAT, respectively). Mean OOP expenditures per patient receiving pharmaceutical care, home visit, and SAT were I$907.56 [confidence interval (CI) I$603.80–I$1269.41], I$148.47 (CI I$109.49–I$194.89), and I$95.35 (CI I$69.11–I$129.63), respectively. The GLM indicated statistically significantly lower OOP expenditures for patients receiving either home visit or SAT (ratio of mean costs 0.247, CI 0.142–0.427; and 0.318, CI 0.187–0.540, respectively) than those receiving pharmaceutical care. Patient’s indirect costs for receiving pharmaceutical care, home visit, and SAT were I$1925.68 (CI I$922.06–I$3284.94), I$2393.66 (CI I$1435.01–I$3501.98), and I$833.33 (CI I$453.87–I$1263.45), respectively. The GLM found no statistically significant differences in indirect costs for the home visit and SAT groups (ratio of mean costs 1.904, CI 0.754–4.802; and 0.792, CI 0.289–2.175, respectively) when pharmaceutical care was set as the reference. Mean utility scores [EuroQol five-dimensional three-level (EQ-5D-3L)] at baseline and treatment end were 0.679 and 0.830, 0.713 and 0.905, and 0.708 and 0.913 for patients receiving pharmaceutical care, home visit, and SAT, respectively.ConclusionPharmaceutical care patients experienced the highest OO...

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Role of pharmaceutical care for self-administered pulmonary tuberculosis treatment in Thailand

Abstract: Pharmaceutical care, home visit and modified DOT are all associated with high success rate for pulmonary TB treatment and exceeded the WHO target, in this retrospective analysis.

Cited by 6 publications

References 18 publications

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

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

Healthcare Resource Uses and Out-of-Pocket Expenses Associated with Pulmonary TB Treatment in Thailand

Out-of-Pocket Expenditures, Indirect Costs and Health-Related Quality of Life of Patients with Pulmonary Tuberculosis in Thailand

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