Engaging Community Pharmacists in Tuberculosis-directly Observed Treatment: a Mixed-methods Study

Overview

Journal Prim Health Care Res Dev

Publisher Cambridge University Press

Specialties Health Services
Public Health

Date 2023 Mar 22

PMID 36946302

Authors

Yen Jun Wong

Chern Choong Thum

Khuen Yen Ng

Shaun Wen Huey Lee

Affiliations

Soon will be listed here.

Abstract

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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References

Antunes A, Gomes J, Belchior I, Loureiro A, Carvalho A, Madeira A . Involvement of pharmacies in tuberculosis treatment. Eur Respir J. 2012; 40(6):1581-2. DOI: 10.1183/09031936.00005012. View

Lonnroth K, Karlsson M, Lan N, Buu T, Dieu T . Referring TB suspects from private pharmacies to the National Tuberculosis Programme: experiences from two districts in Ho Chi Minh City, Vietnam. Int J Tuberc Lung Dis. 2003; 7(12):1147-53. View

Sekandi J, Buregyeya E, Zalwango S, Dobbin K, Atuyambe L, Nakkonde D . Video directly observed therapy for supporting and monitoring adherence to tuberculosis treatment in Uganda: a pilot cohort study. ERJ Open Res. 2020; 6(1). PMC: 7132038. DOI: 10.1183/23120541.00175-2019. View

Jokanovic N, Tan E, Sudhakaran S, Kirkpatrick C, Dooley M, Ryan-Atwood T . Pharmacist-led medication review in community settings: An overview of systematic reviews. Res Social Adm Pharm. 2016; 13(4):661-685. DOI: 10.1016/j.sapharm.2016.08.005. View

Story A, Aldridge R, Smith C, Garber E, Hall J, Ferenando G . Smartphone-enabled video-observed versus directly observed treatment for tuberculosis: a multicentre, analyst-blinded, randomised, controlled superiority trial. Lancet. 2019; 393(10177):1216-1224. PMC: 6429626. DOI: 10.1016/S0140-6736(18)32993-3. View

Garfein R, Liu L, Cuevas-Mota J, Collins K, Munoz F, Catanzaro D . Tuberculosis Treatment Monitoring by Video Directly Observed Therapy in 5 Health Districts, California, USA. Emerg Infect Dis. 2018; 24(10):1806-1815. PMC: 6154139. DOI: 10.3201/eid2410.180459. View

Lei X, Liu Q, Escobar E, Philogene J, Zhu H, Wang Y . Public-private mix for tuberculosis care and control: a systematic review. Int J Infect Dis. 2015; 34:20-32. DOI: 10.1016/j.ijid.2015.02.015. View

Guhl D, Blankart K, Stargardt T . Service quality and perceived customer value in community pharmacies. Health Serv Manage Res. 2018; 32(1):36-48. DOI: 10.1177/0951484818761730. View

Malmborg R, Mann G, Squire S . A systematic assessment of the concept and practice of public-private mix for tuberculosis care and control. Int J Equity Health. 2011; 10:49. PMC: 3238294. DOI: 10.1186/1475-9276-10-49. View

10.

Cai J, Wang X, Ma A, Wang Q, Han X, Li Y . Factors associated with patient and provider delays for tuberculosis diagnosis and treatment in Asia: a systematic review and meta-analysis. PLoS One. 2015; 10(3):e0120088. PMC: 4373856. DOI: 10.1371/journal.pone.0120088. View

11.

Bell C, Ilomaki J, Pichenda K, Duncan G, Saini B . Referral of tuberculosis symptomatic clients from private pharmacies to public sector clinics for diagnosis and treatment in Cambodia. J Eval Clin Pract. 2015; 21(2):285-91. DOI: 10.1111/jep.12306. View

12.

Damschroder L, Aron D, Keith R, Kirsh S, Alexander J, Lowery J . Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009; 4:50. PMC: 2736161. DOI: 10.1186/1748-5908-4-50. View

13.

Konduri N, Delmotte E, Rutta E . Engagement of the private pharmaceutical sector for TB control: rhetoric or reality?. J Pharm Policy Pract. 2017; 10:6. PMC: 5241918. DOI: 10.1186/s40545-016-0093-3. View

14.

Juan G, Lloret T, Perez C, Lopez P, Navarro R, Ramon M . Directly observed treatment for tuberculosis in pharmacies compared with self-administered therapy in Spain. Int J Tuberc Lung Dis. 2006; 10(2):215-21. View

15.

Balogun M, Sekoni A, Meloni S, Odukoya O, Onajole A, Longe-Peters O . Trained community volunteers improve tuberculosis knowledge and attitudes among adults in a periurban community in southwest Nigeria. Am J Trop Med Hyg. 2014; 92(3):625-32. PMC: 4350563. DOI: 10.4269/ajtmh.14-0527. View

16.

Al-Babtain B, Cheema E, Hadi M . Impact of community-pharmacist-led medication review programmes on patient outcomes: A systematic review and meta-analysis of randomised controlled trials. Res Social Adm Pharm. 2021; 18(4):2559-2568. DOI: 10.1016/j.sapharm.2021.04.022. View

17.

Carson-Chahhoud K, Livingstone-Banks J, Sharrad K, Kopsaftis Z, Brinn M, To-A-Nan R . Community pharmacy personnel interventions for smoking cessation. Cochrane Database Syst Rev. 2019; 2019(10). PMC: 6822095. DOI: 10.1002/14651858.CD003698.pub3. View

18.

Tola H, Tol A, Shojaeizadeh D, Garmaroudi G . Tuberculosis Treatment Non-Adherence and Lost to Follow Up among TB Patients with or without HIV in Developing Countries: A Systematic Review. Iran J Public Health. 2015; 44(1):1-11. PMC: 4449995. View

19.

Dong Y, Peng C . Principled missing data methods for researchers. Springerplus. 2013; 2(1):222. PMC: 3701793. DOI: 10.1186/2193-1801-2-222. View

20.

Zawahir S, Le H, Nguyen T, Beardsley J, Duc A, Bernays S . Standardised patient study to assess tuberculosis case detection within the private pharmacy sector in Vietnam. BMJ Glob Health. 2021; 6(10). PMC: 8496389. DOI: 10.1136/bmjgh-2021-006475. View