Pharmaceutical care model for antituberculosis drug therapy in tuberculosis patients at a primary healthcare centre in Surabaya, East Java, Indonesia

Abstract

Background: Indonesia ranks third in the world for tuberculosis (TB), which remains a public health problem, where the role of health workers, including pharmacists, is needed. The role of pharmacists in primary health care centres is still limited to providing fixed-dose combination antituberculosis drugs (FDC) as a product. The provision of drugs as a means of therapy through pharmaceutical care in TB patients is still not optimal. Objective: This study aimed to create a pharmaceutical care model to improve adherence to FDC treatment regimens in TB patients at the primary health care centre. Methods: The study consisted of three stages, with the unit of analysis being pharmacist. The first stage was mapping the profile of FDC services in TB patients. The second stage was the creation of pharmaceutical care training modules. The third stage was testing the pharmaceutical care model with module training for pharmacists. The first stage of the study was an observational analytic cross-sectional design, including 63 pharmacists and 249 TB patients from July to September 2018. The third stage of the study was a quasi-experimental design with a pre-test post-test control group in October 2018, enrolling 36 pharmacists divided into 18 pharmacists in the intervention group and 18 pharmacists in the control group. The research was approved by the Health Research Ethics Commission, Faculty of Public Health, Universitas Airlangga. Results: The results consisted of a model of pharmaceutical care in TB patients. Pharmacists knowledge affects their abilities, including verification, explanation of indications, effectiveness, safety, and adherence. Pharmacists ability to influence patient response includes belief, understanding, expectation, concern, and adherence to the drug therapy regimen. Conclusion: The pharmaceutical care model improved adherence to the FDC therapy regimen in TB patients at the primary healthcare centre.