Abstract
Tuberculosis (TB) hampered with poor patient compliance and intolerance at least partially due to adverse drug reactions (ADRs). A prospective observational and interventional healthcare teamwork study was carried out to implement a self-reporting pharmacovigilance system in TB patients through a knowledge based approach in the Pulmonology department of Kovai Medical Center and Hospital (KMCH) at Coimbatore. A patient information pamphlet which was endorsed by the pulmonology associates was the core tool for this study. A well practiced and skilled clinical pharmacist educated the patients and enabled them to report the ADRs due to anti tubercular drugs through the emergency number given in the pamphlet. Totally 110 patients enrolled in the study. 43 (39%) patients experienced 74 numbers of ADRs during the intensive phase therapy. Out of 110 patients, 101 were adhered to the intensive phase therapy. Of the 74 ADRs experienced to our study population, 24 ADRs were occurred in 18 patients which are needed to be self reported by the patient according to the study protocol. Among 24 ADRs which have to be self reported, 20 (83.33%) ADRs were reported through 17 calls by 16 patients. The self-reporting pharmacovigilance for anti-tubercular therapy in pulmonology department of KMCH, Coimbatore, were implemented and was certified by the pulmonology associates. Our study concludes that if a proper educational system is implemented, most of the patients were ready to report their ADR of any drug and thereby we can improve both patient adherence and reducing the severity of ADRs. It is suggested that the pharmacists should exhibit their vital role during TB therapy in TB centres, pulmonology departments and DOTS centres to guarantee a better patient care.
Highlights
Tuberculosis (TB) is the most rampant communicable infectious disease on earth and remains out of control in many developing nations
Non compliance is cited as the major problem to the control of tuberculosis at the level of public health and which escort to the drug resistance in case of TB [2,3,4]
According to World Health Organization (WHO) and several other studies concluded that, the poor out-come was attributed to poor patient compliance, to primary multidrug resistance and to interruption partially due to adverse drug reactions (ADRs) (WHO 1997) [3,7,8,13,15,16,17,18,19] and the towering incidence of TB infection has caused a high occurrence of morbidity and mortality which is partly due to serious ADRs induced by Anti- TB drugs [12]
Summary
Tuberculosis (TB) is the most rampant communicable infectious disease on earth and remains out of control in many developing nations. The lack of knowledge about the treatment and ATT induced ADRs are the two major factors which leads to the patient’s non-adherence to the TB therapy. Majority of them are due to the lack of knowledge about the importance of the completion of therapy Out of these 16 factors 37.80% (which is the highest percentage) of patients were non adherent due to the severe ADRs [20]. Several studies were suggesting the significance of a new system for premature detection of ADR for a better patient care [8,10,21] This leads to taking a decision to do an intervention of a new health care teamwork approach with an intention to complete patient care during ATT with a special preference on ADR reporting system. This study is one of the clinical pharmacy come health care team work oriented one, aiming for the best quality of life of tuberculosis patient during their therapy by implementing an educational approach to them regarding on both the therapy and how to counteract the possible ADRs during Anti Tubercular Therapy
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