Evaluation of the impact of pharmaceutical care for tuberculosis patients in a Secondary Referral Outpatient Clinic, Minas Gerais, Brazil

Abstract

Pharmaceutical care is a professional practice seeking the responsible provision of drug therapy by identifying, resolving, and preventing Drug-Related Problems (DRP). The study aims to describe and evaluate the impact of pharmaceutical care given to patients being treated for tuberculosis (TB). Study concurrent, longitudinal, prospective conducted during pharmaceutical care in the TB outpatient clinic, Clinical Hospital, Federal University of Minas Gerais during the period August 2009 to July 2012. The Pharmacotherapy Workup proposed by Cipolle et al. (2004) was used. Statistical analyses were performed by X 2 or Fisher exact test, as appropriate. A total of 62 patients were followed up, and 128 drug-related problems (DRP) were identified: 69.5% related to safety, 13.3% to effectiveness, 12.5% to indication, and 4.7% to treatment adherence, and 62.1% of the DRP were resolved. A total of 115 pharmaceutical interventions were performed. The impact of pharmaceutical care was satisfactory for 73.9% of patients with a resolution rate of 77%. There was a greater impact on pharmaceutical care (index ≥ 0.50) for those patients who were not smokers (p <0.05). The impact of pharmaceutical care was important, so the pharmacist should work alongside the multidisciplinary team to monitor treatment and perform interventions.

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

“…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.…”

“…Those focused on community pharmacy included three which specifically analyzed the role of pharmacy in improving LTBI treatment [ 14 , 16 , 18 ], and one investigated community pharmacists as directly observed treatment (DOT) providers to improve the rational use of TB medication [ 20 ]. In the hospital pharmacy service, all studies analyzed PC activities in the hospital regarding the assessment, monitoring, and follow-up of patient DRPs, educational programs for medication adherence, direct/indirect scheduled meeting, and medication consultation [ 19 , 21 , 22 , 23 , 24 ]. PC models and their effects on TB treatment outcomes are presented in Table 3 .…”

Implementation and Effectiveness of a Pharmacotherapeutic Follow-Up Service for People with Tuberculosis in Primary Healthcare

“…In Brazil, two studies described the results of PFU services in secondary healthcare based on the Pharmaceutical Care Practice offered to 81 and 62 people with TB [ 7 , 25 ]. Resende et al [ 7 ] found that 80% of patients had at least one drug therapy problem (DTP) identified in their pharmacotherapy, while Lopes et al [ 25 ] pointed to a total of 128 identified DTPs, of which 77% were resolved.…”

“…In Brazil, two studies described the results of PFU services in secondary healthcare based on the Pharmaceutical Care Practice offered to 81 and 62 people with TB [ 7 , 25 ]. Resende et al [ 7 ] found that 80% of patients had at least one drug therapy problem (DTP) identified in their pharmacotherapy, while Lopes et al [ 25 ] pointed to a total of 128 identified DTPs, of which 77% were resolved. In contrast to the present study, the impact of the services offered on clinical outcomes was not evaluated, although the resolution of DTPs has the potential to improve health outcomes [ 7 , 25 ].…”

Dimensões utilizadas na avaliação da qualidade organizacional dos serviços que atendem pessoas com tuberculose: uma revisão sistemática

“…Dois estudos ressaltaram o papel da assistência farmacêutica para investigar e solucionar problemas relacionados a medicamentos, um para TB [96] e outro para ILTB [79]. Van Hoorn e col. [54] associaram o suporte psicoemocional ao sucesso do tratamento, e Tola [49] Entre as estratégias utilizadas para adesão, estudos citaram a visita domiciliar e o Tratamento diretamente observado (TDO).…”