Pharmacists’ Role in Global TB Elimination: Practices, Pitfalls, and Potential

Author:

Cernasev Alina1ORCID,Stillo Jonathan2ORCID,Black Jolie3,Batchu Mythili4,Bell Elaina2,Tschampl Cynthia A.3ORCID

Affiliation:

1. Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Nashville, TN 37211, USA

2. Department of Anthropology, Wayne State University, 656 W. Kirby St. 3054 FA/B, Detroit, MI 48202, USA

3. Schneider Institutes for Health Policy and Research, The Heller School for Social Policy and Management, Brandeis University, Waltham, MA 02453, USA

4. Department of Public Health, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Davie, FL 33313, USA

Abstract

Tuberculosis (TB) is the top infectious killer in the world despite efforts to eliminate it. Pharmaceutical care roles are pillars of pharmacy practice, and pharmacists are well equipped to serve a unique role in the pathway to provide education about TB. Previous systematic reviews emphasize pharmacists’ role in treating TB; however, pharmacists can and do play much broader roles in overall TB elimination efforts. Five researchers searched five electronic databases (PubMed, PsychInfo, CINAHL, Academic Search Premier, and Embase). Search terms included pharmacy, pharmacist, tuberculosis, antitubercular agents, supply, distribution, and drug therapy. Inclusion criteria were studies published from 2010 through March 2023, in English or Spanish, addressed a specific TB-related role for pharmacists/pharmacies, and were peer-reviewed. Exclusion criteria included pharmacology, pharmacokinetics, clinical trials on drug efficacy, and editorials. Two researchers conducted each level of review; for discordance, a third researcher reviewed, and a decision was reached by consensus. Roles were extracted and cross-referenced with traditional pharmaceutical care steps. Of the initial 682 hits, 133 were duplicates. After further review, we excluded 514 records, leaving 37 articles for full extraction. We found nine roles for pharmacists in TB prevention and classified them as implemented, not implemented, or recommended. These roles were: (1) TB symptom screening; (2) Referring to TB care systems; (3) TB testing; (4) Dispensing TB medication correctly and/or directly observed therapy; (5) Counseling; (6) Looking to reduce socioeconomic barriers; (7) Procurement of TB medications; (8) Quality assurance of TB medications; (9) Maintaining and using pharmacy data systems. Pharmacists are well situated to play a vital role in the global fight against TB. Findings suggested pharmacists in many settings have already expanded their roles related to TB elimination beyond traditional pharmaceutical care. Still others need to increase the understanding of TB procurement and treatment, their power to improve TB care, and their contributions to data systems that serve population health. Pharmacy curricula should increase TB-related training to better equip future pharmacists to contribute to TB elimination.

Publisher

MDPI AG

Reference74 articles.

1. Ryan, F. (1993). The Forgotten Plague: How the Battle against Tuberculosis Was Won—And Lost, Little, Brown. [1st ed.].

2. McMillen, C.W. (2015). Discovering Tuberculosis: A Global History, 1900 to the Present, Yale University Press.

3. Bedaquiline: First FDA-approved tuberculosis drug in 40 years;Mahajan;Int. J. Appl. Basic Med. Res.,2013

4. World Health Organization (2024, March 21). Global Tuberculosis Report 2015, 20th ed. Available online: https://www.who.int/publications-detail-redirect/9789241565059.

5. World Health Organization (2023). WHO Global Tuberculosis Report 2023, World Health Organization. Available online: https://iris.who.int/bitstream/handle/10665/373828/9789240083851-eng.pdf?sequence=1.

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