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Role of pharmaceutical care for self‐administered pulmonary tuberculosis treatment in Thailand
Author(s) -
Tanvejsilp P.,
Pullenayegum E.,
Loeb M.,
Dushoff J.,
Xie F.
Publication year - 2017
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/jcpt.12519
Subject(s) - medicine , propensity score matching , pulmonary tuberculosis , pharmaceutical care , retrospective cohort study , directly observed therapy , tuberculosis , cohort , cohort study , emergency medicine , intensive care medicine , family medicine , pharmacy , pathology
Summary What is known and objective With resource constraints in Thailand, directly observed therapy ( DOT ) for treating tuberculosis ( TB ) may not be feasible to implement. To improve patients' adherence, hospitals either modify DOT or adopt different approaches: pharmaceutical care or home visit. Our objective was to assess pulmonary TB treatment success rate of pharmaceutical care compared to home visit and modified DOT in Thailand. Methods We conducted a retrospective cohort study using data collected in adult pulmonary TB patients starting treatment between October 2010 and September 2013 in three hospitals in Thailand. This study was approved by the Research Ethics Board at each of the participating hospitals. We built a propensity score matching to account for differences in patient baseline characteristics. Results Analysis included 1398 patients. Before matching, the treatment success rate for patients receiving pharmaceutical care was 94.9%, home visit 93.6% and modified DOT 90.1%. The propensity score‐matched cohorts indicated that differences in the treatment success rate were not statistically significant when comparing pharmaceutical care with either home visit (success rate: 92.76% vs 94.74%, risk difference: 1.97%, 95% CI −3.64 to 7.59) or modified DOT (success rate 93.37% for both, risk difference: 0%, 95% CI −5.30 to 5.30). What is new and conclusion 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.