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Perceived Barriers and Facilitators to Community Pharmacy-based Tuberculosis Service in Malaysia

  • At: PPR 2022 (2022)
  • Type: Poster
  • Poster code: PT-26
  • By: WONG, Yen Jun (Monash University Malaysia)
  • Co-author(s): Yen Jun Wong, Phd Candidate, Monash University Malaysia, Malaysia
    Khuen Yen Ng, Senior lecturer
    Shaun Wen Huey Lee, Associate Professor
  • Abstract:

    Title:
    Perceived Barriers and Facilitators to Community Pharmacy-based Tuberculosis Service in Malaysia

    Background information:
    Tuberculosis (TB) remains one of the public health concerns in Malaysia. While TB mortality rates have decreased over the years, proactive initiatives are required to further reduce TB incidence and improve the treatment success rates. With the success of community pharmacist-led interventions in medication review and smoking cessation service in Malaysia, community pharmacy-based TB management can serve as a value-added strategy to the national TB control and prevention program.

    Purpose:
    A mixed-methods study was conducted in Malaysia to evaluate community pharmacists’ perception on a proposed community pharmacy-based value-added TB service to improve TB case detection and treatment completion.

    Methods:
    Community pharmacists in Malaysia were invited to participate in an online self-administered survey, followed by a semi-structured interview for congruency between March to October 2021. The survey was developed using the Consolidated Framework for Implementation Research, and aimed to assess the potential barriers and facilitators on community pharmacy based TB service including referrals, TB directly observed therapy (DOT), and TB education. The survey instrument was validated for content and face validity, followed by a pilot test before administration. Quantitative data were analyzed using descriptive analysis, while qualitative data were analyzed using thematic analysis.

    Results:
    A total of 388 community pharmacists completed the survey, of which 23 participated in the interview. The respondents had a median age of 29.0 years with a median of three-year working experience. 83.5% of the respondents believed a structured TB referral system is needed, with 73.5% believing that community pharmacy-based TB DOT service is beneficial for treatment adherence, and 87.1% believed community pharmacists should play a role in public education about TB. Most respondents were willing to provide TB referrals (97.2%), offer TB DOT (70.1%) and provide TB education (99.6%). Some respondents were hesitant to offer services as they lacked confidence (53.4%) and knowledge (40.0%) in TB management, in addition to the complicated process needed to set up a designated area to deliver TB service to ensure good infection control (53.4%). In the qualitative analysis, three main themes emerged. Respondents felt that the community pharmacy-based TB intervention was viewed as a positive opportunity to (1) enhance professional role of pharmacists in patient-centered care; (2) engage and educate the community about TB in order to overcome the stigma towards TB; (3) encourage multidisciplinary collaboration in sharing professional responsibilities in TB management.

    Conclusions:
    As we work towards the milestone of ending the global TB epidemic by 2035, community pharmacists in Malaysia were supportive of community pharmacy-based TB service. There is a need for collaboration and contribution from all stakeholders to upscale the effort in TB control and prevention. In order to integrate community pharmacy-based TB intervention into practice, training and accreditation, infection control strategies and standard operating procedures have to be in place to ensure a successful implementation.

Last update 4 October 2019

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