Characteristics, knowledge, attitude, and practice of pharmacy personnel in supporting tuberculosis treatment: A multicentre cross-sectional study in a high-burden tuberculosis country

J Am Pharm Assoc (2003). 2024 Mar 25:102077. doi: 10.1016/j.japh.2024.102077. Online ahead of print.

Abstract

Background: Positive roles of community pharmacy in TB care have been widely reported. However, the actual practice of supporting TB treatment is not optimal yet. Therefore, we analyzed the current practice of community pharmacy personnel and its factors in supporting the successful treatment of TB patients in Indonesia, aiming to develop strategies for effective and sustainable TB practice models for the community pharmacy.

Methods: We performed a cross-sectional survey in three areas representing Indonesia's eastern, central, and western parts. Development and validation of the questionnaire were conducted to assess four domains, i.e., characteristics, knowledge, attitudes, and practice of community pharmacy personnel in supporting the successful treatment of TB patients. Data were collected with purposive convenience sampling using online and offline questionnaires. Descriptive analyses were used to summarize factors in each domain, while binary logistic regression was used to analyze the associated factors of the practice.

Results: Thirty-five questionnaire items indicated a valid instrument, and the study successfully included 844 participants who comprised pharmacists (n= 473, 56%) and pharmacy assistants (n= 371, 44%). Although most of the knowledge items were correctly answered by more than 60% of the participants, items related to TB signs, risk groups, drug regimens, and medicine uses were still less than 60%. This was in line with exposure to updated TB training in only 51% of the participants (n= 426). Most of the participants had a positive attitude toward their professional role (n= 736, 87%), capability (n= 646, 77%), and consequences (n= 655, 78%) in supporting TB treatment. However, this was not aligned with the actual practice of supporting TB treatment, intensively performed by only 1.3% of participants (n=11). We identified several factors associated with the practice, i.e., a pharmacy assistant background (p<0.05), short working time (p<0.05), experience in TB training (p<0.001), and a positive attitude (p<0.001).

Conclusions: This study highlighted a limited number of community pharmacy personnel practising as TB treatment supporters in Indonesia. An interventional package considering the identified factors is needed to develop effective and sustainable practices in the real world.

Keywords: Indonesia; pharmaceutical care; public-private mix; treatment supporter.