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http://www.ajhp.org/cgi/content/abstract/64/5/497
Effect of pharmacist-ledpatient education on adherence to tuberculosis treatment
Philip M. Clark,Turan Karagoz, Sule Apikoglu-Rabus and FikretVehbi Izzettin
PHILIPM. CLARK, PH.D.,is Clinical Pharmacy Tutor, Department of Pharmacy, YeditepeUniversity, Kayisdagi, Istanbul, Turkey.TURAN KARAGOZ, M.D., is Consultant RespiratoryPhysician, Sureyyapasa Center for Chest Diseases and Thoracic Surgery,Maltepe, Istanbul.SULE APIKOGLU-RABUS, M.S., is Researchand Teaching Assistant; and FIKRET VEHBI IZZETTIN, PH.D., is Professor of Clinical Pharmacy, School of Pharmacy,Marmara UniversityPharmacy School,Istanbul.
Address correspondence to Dr.Clark at the Department of Pharmacy, YeditepeUniversity, 26 Agustos Campus,Kayisdagi Street 81120, Kayisdagi, Istanbul, Turkey (pmclark@yeditepe.edu.tr<!-- var u = \"pmclark\", d = \"yeditepe.edu.tr\"; document.getElementById(\"em0\").innerHTML = &#39;<a href=\"mailto:&#39; + u + &#39;@&#39; + d + &#39;\">&#39; + u + &#39;@&#39; + d + &#39;<\\/a>&#39;//-->).

Purpose. The purpose of this study was to assess the effect[sup] [/sup]of a clinical pharmacist-directed patient education program[sup] [/sup]on the therapy adherence of first-time tuberculosis (TB) patients[sup] [/sup]and to identify the major pharmaceutical care needs and issues[sup] [/sup]of first-time TB and multidrug-resistant (MDR)-TB patients.[sup] [/sup] Methods. In the first part of the study, first-time TB patients[sup] [/sup]were randomized either to the No EDU group (n = 58) where patients[sup] [/sup]received routine medical and nursing care or to the EDU group[sup] [/sup](n = 56) where patients were also provided with clinical pharmacist-directed[sup] [/sup]patient education. The patient’s adherence to treatment[sup] [/sup]was evaluated by attendance at scheduled visits, medication[sup] [/sup]counting, and urine analysis for the presence of isoniazid metabolites.[sup] [/sup]In the second part of the study, the pharmaceutical care needs[sup] [/sup]and issues were determined for first-time TB patients and for[sup] [/sup]MDR-TB patients (n = 40).[sup] [/sup] Results. The adherence of patients who received pharmacist-directed[sup] [/sup]patient education was greater than that of patients who did[sup] [/sup]not. The attendance at scheduled visits and urine analysis for[sup] [/sup]the presence of isoniazid metabolites yielded better results[sup] [/sup]in respect to adherence for the EDU group (p < 0.05), while[sup] [/sup]medication counting did not differ between the two groups. The[sup] [/sup]major pharmaceutical care needs of first-time TB patients were[sup] [/sup]for pain control, nutrient replacement, appropriate prescribing,[sup] [/sup]respiratory control, and diabetic control. Similar findings[sup] [/sup]were recorded for MDR-TB patients.[sup] [/sup] Conclusion. Patients’ adherence to TB treatment improved[sup] [/sup]when a pharmacist provided patient education on medication use[sup] [/sup]and addressed patients’ pharmaceutical care issues.[sup] [/sup] Index terms: Antituberculars; Clinical pharmacists; Compliance; Isoniazid; Patient information; Patients; Pharmaceutical care; Rational therapy; Resistance; Tuberculosis

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