Development of a pharmaceutical care model for patients with multidrug-resistant tuberculosis

Abstract

Abstract

          Objectives:1.To study the incidence of drug-related problems in patients with multidrug-resistant tuberculosis. 2.To evaluate the outcomes of pharmaceutical care on treatment results and the occurrence of drug-related problems in patients with multidrug-resistant tuberculosis (MDR-TB). 3.To develop a pharmaceutical care model for patients with multidrug-resistant tuberculosis, aiming to meet higher standards on the medication safety evaluation scale.Study Methodology: quasi-experimental study was conducted on all patients diagnosed with multidrug-resistant tuberculosis who received treatment at the outpatient tuberculosis clinic, totaling 47 patients. They were divided into two groups: a control group consisting of 27 patients who started their medication from October 1, 2020, to December 31, 2021, and an experimental group of 20 patients who started medication from April 1, 2022, to June 30, 2023, and received enhanced pharmaceutical care. Data were collected retrospectively from medical records and pharmaceutical care documentation for both groups. Descriptive statistics were used for general data analysis. Fisher's exact test was used to compare qualitative data between the control and experimental groups. For quantitative data comparisons between the groups, an independent sample t-test was applied when the data were normally distributed, and a chi-square test was used for other distributions, with a significance level set at 0.05.Results: There were no significant differences in gender, age, BMI, or comorbidities between the control and experimental groups (P > 0.05), except for the regimen, which showed a significant difference (P = 0.018). Adverse drug reactions occurred in 81.5% of the control group and 85% of the experimental group, with no statistically significant difference (P = 0.754). After the occurrence of adverse reactions, 4.5% of the control group still had symptoms, and 4.5% died, whereas the experimental group had a 100% recovery rate. Regarding the development of the pharmaceutical care model, the treatment success rate in the control group was 55.6%, and 29.6% of patients died. In the experimental group, the treatment success rate increased to 80%, and the mortality rate decreased to 10%, though this difference was not statistically significant (P = 0.121). There were no statistical differences in the occurrence of adverse drug reactions between the two groups (P = 1.000).Conclusion: The development of the pharmaceutical care model showed a trend toward increased treatment success, reduced mortality, and improved medication adherence, although these differences were not statistically significant. The model also contributed to a reduction in mortality related to adverse drug reactions and led to higher standards in medication safety, improving the medication safety evaluation scale from level 2 to level 3.

Keywords: Pharmaceutical care, drug-related problems, multidrug-resistant tuberculosis