2. Community Pharmacists Monitoring of Pulmonary Tuberculosis Outpatients (Preliminary Study)

3. Authors Usasiri Srisakul, M.Sc. in Pharm (Clinical Pharmacy)
Phayom Sookaneknun, PharmD
Sunantha Osiri, Ph.D
Institution:
Faculty of Pharmacy and Health Sciences,
Mahasarakham University, Thailand, 44150
Study funded by:
Health Systems Research Institute (HSRI),
Thailand

4. Introduction
DOTS (Directly Observed Treatment, Short Course) for pulmonary tuberculosis (PulTB) is a major strategy in the National Tuberculosis Programme (NTP) following WHO global plan.
Thailand ranked the 16th in 22 high-burden countries.

5. Objectives To compare clinical outcome between
Community pharmacists monitoring patients
Control patients receiving normal care

6. Method Quasi experimental study design Patients: Preliminary study:
Pulmonary Tuberculosis (PulTB) without HIV co-infection
DOT category 1 (2HRZE + 4HR)
December 2002 – January 2004
Mahasarakham provincial hospital
Preliminary study:
December 2002 – October 2003
N = 54

7. PulTB with DOT category1 N=54
Completed intensive
treatment phase
2nd month
Volunteered
Community pharmacists
monitoring group
N=27
Control group
N=27
3rd – 5th month
Clinical outcomes
6th month
Figure 1 Research procedure

8. Method (cont.) Community Pharmacists monitoring group Control group
Refill of DOTS medication (1-4 weekly follow up)
Pharmaceutical care
Control group
Normal care from the hospital (1-3 monthly follow up)
Clinical outcomes
Cure rate
Treatment success rate
Default rate
Failure rate

9. Results: Demographic data
Treatment gr.
Control gr.
p-value
N=27
Age (year)
0.495
Male (%)
16 (47.10%)
18 (52.90%)
0.573
Smear positive (%)
17 (63.00%)
12 (44.44%)
0.172
No significant differences in all demographic data betweent both groups.

10. Results: Clinical outcomes
Treatment gr.
Control gr.
p-value
N=27
Cure rate
94.12% (16)
66.67% (8 )
0.054
Treatment
Success rate
96.30% (26)
74.10% (20)
0.022*
Default rate
3.7% (1)
22.22% (6)
0.043*
Failure rate
0% (0)
0.313
* Significant differences

11. Results: Clinical outcomes
0.022*
0.054
0.043*
0.313
Figure 2 Clinical outcomes

12. Discussion
Community pharmacist monitoring can improve treatment succes rate (WHO goal > 85%), decrease default and failure rate
Show the community pharmacist involvement in DOTS multidisciplinary team
In the future study should be expanded number of patients, community pharmacy setting and referral system

13. Conclusion
Community pharmacist involvement in a DOTS multidisciplinary team improved clinical outcomes in pulmonary tuberculosis outpatients.

14. Thank you very much