Can we involve pharmacists as direct service providers for people with tuberculosis? A narrative review of current evidence

Abstract

Background

Effective management of tuberculosis (TB) necessitates the utilization of all available healthcare resources. Despite a paradigm shift in pharmacy practice from a product-centric to a patient-centered model, pharmacists remain underutilized in direct TB care. This narrative review explores the role of pharmacists in TB management, highlighting the effects of direct pharmaceutical care (PC) practices for TB treatment outcomes by identifying challenges and proposing strategic interventions to enhance pharmacists' engagement in TB services.

Methods

We conducted a literature search across major medical databases to describe existing studies on the effect of direct PC practice on TB case management. We then discussed the challenges and potential strategies for its implementation.

Results

We identified several PC models, including drug therapy monitoring, home-based care, patient counseling, and adherence support. These models mitigate drug-related problems, adverse drug reactions, and medication non-adherence. However, pharmacists face numerous barriers to providing direct TB care, including insufficient clinical training, limited interdisciplinary collaboration, a lack of organizational support and incentives, inadequate regulatory frameworks, and low awareness of pharmacists' potential contributions. To address these challenges, proposed strategies include strengthening pharmacist education and training, fostering collaboration within healthcare teams, developing standardized practice guidelines, ensuring adequate facilities and financial support, and increasing awareness among policymakers and the public on pharmacists' roles in TB care.

Conclusion

Strengthening the role of pharmacists in TB management requires a multi-faceted approach involving targeted policy reforms, enhanced professional training, and interdisciplinary collaboration. A coordinated effort among national and local TB programs, healthcare institutions, professional organizations, and academic institutions is essential to optimize pharmacists' contributions to TB prevention, treatment, and patient support.