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Referral of tuberculosis symptomatic clients from private pharmacies to public sector clinics for diagnosis and treatment in C ambodia
Author(s) -
Bell Carolyn A.,
Ilomäki Jenni,
Pichenda Koeut,
Duncan Gregory J.,
Saini Bandana
Publication year - 2015
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/jep.12306
Subject(s) - medicine , referral , tuberculosis , pharmacy , public sector , family medicine , private sector , patient referral , public health , intensive care medicine , nursing , pathology , economy , economics , economic growth
Abstract Rationale, aims and objectives C ambodia is one of the 22 countries with a high burden of tuberculosis ( TB ). People often first seek treatment for cough and other TB symptoms through private pharmacies. The N ational T uberculosis P rogramme trained willing private sector pharmacies to refer TB symptomatic clients to their closest public sector clinic for diagnosis and treatment. The study objective was to investigate factors associated with referral of TB symptomatic clients from pharmacies to public sector clinics in P hnom P enh, C ambodia. Method Face‐to‐face structured interviews were conducted with staff from a stratified random sample of 180 private pharmacies in P hnom P enh in 2012. Trained interviewers were K hmer speakers. Logistic regression was used to compute odds ratios ( OR s) and 95% confidence intervals ( CI s) for factors associated with self‐reported referral during the previous 3 months. Results Fifty (29.6%) pharmacies reported that they had referred 125 clients (range 1–10) to public sector clinics during the previous 3 months. In total, 164 (96.5%) pharmacies reported that they always referred all TB symptomatic clients to DOTS (directly observed treatment, short course) clinics. More than 6‐year participation in the programme ( OR 5.23, 95% CI 1.93–14.18) and willingness to always continue referring ( OR 12.24, 95% CI 11.61–93.10) were associated with referral of one or more clients in the previous 3 months. Referral to the client's closest clinic was negatively associated with referral ( OR 0.45, 95% CI 0.23–0.99). Conclusion Pharmacies' ongoing commitment to the R eferral P rogramme was strongly associated with referral. Increased advocacy among the high number of non‐referring pharmacies may improve programme performance. Factors negatively associated with referral may need investigation.