Pharmacotherapy of Different Tuberculosis Patients its Analysis and Outcomes: A Retrospective Cohort Study

Asim Shahzad*; Muhammad Farhad Anwar; Abrar Hussain Mian; Abdul Rehman; Matiullah

**Asim Shahzad*, Muhammad Farhad Anwar, Abrar Hussain Mian, Abdul Rehman and Matiullah**

Volume2-Issue11
Dates: Received: 2021-11-09 | Accepted: 2021-11-27 | Published: 2021-11-29
Pages: 1154-1158

Abstract

This study aim was to evaluate the prescribed therapies and to identify various drug-related problems as well as their causes in different TB patients admitted at the Pulmonology Department, Northwest General Hospital and Research Centre, Hayatabad, Peshawar, Pakistan. A 5-month retrospective study was conducted in which a total of 525 patients’ medical records were collected using predesigned standard data collection proforma. Among them, 25 patients having incomplete medical records were excluded and the rest of 500 cases were involved and analyzed accordingly. In all these cases, the causative agent was Mycobacterium tuberculosis. Overall 14 drugs of 133 different therapeutic classes were used in which the most frequently prescribed drugs to these patients were Anti-Tuberculosis drugs (100%), Antibiotic (100%), Multivitamins (78%), GIT drugs (55%) and Antihistamines (55%) followed by other drugs listed in the present study. Out of 500 cases, a total of 179 (35.8%) patients were identified had Drug-related problems, among them 23 (4.6%) cases were in untreated condition, in 12 (2.4%) cases drugs without indication problems were found, in 43 (8.6%) cases there were adverse drug reactions problems noted, in 75 (15%) cases total drug interactions problems were identified, while in 26 (5.2%) cases polypharmacy problems were found. The prescribed pharmacotherapy in all 500 cases meets with the standard pharmacotherapy. However, the discrepancies observed in the present study were due to lack of proper knowledge about the pharmacology of the drugs, overburden on doctors and proper lack of patient counseling. To better understand the proper management and reduction of these problems other health care professionals and proper clinical pharmacists are required to cooperate for the sake of improving the outcomes of the pharmacotherapy.

FullText HTML FullText PDF DOI: 10.37871/jbres1363

Certificate of Publication

Copyright

How to cite this article

Shahzad A, Anwar MF, Mian AH, Rehman A, Matiullah. Pharmacotherapy of Different Tuberculosis Patients its Analysis and Outcomes: A Retrospective Cohort Study. J Biomed Res Environ Sci. 2021 Nov 29; 2(11): 1154-1158. doi: 10.37871/jbres1363, Article ID: JBRES1363, Available at: https://www.jelsciences.com/articles/jbres1363.pdf

Subject area(s)

Pharmacology

Epidemiology

Pulmonology

University/Institute

Hazara University

References

Saqib SE, Ahmad MM, Amezcua-Prieto C, Virginia MR. Treatment Delay among Pulmonary Tuberculosis Patients within the Pakistan National Tuberculosis Control Program. Am J Trop Med Hyg. 2018 Jul;99(1):143-149. doi: 10.4269/ajtmh.18-0001. Epub 2018 May 10. PMID: 29761768; PMCID: PMC6085810.
Wani RL. Clinical manifestations of pulmonary and extra-pulmonary tuberculosis. South Sudan Medical Journal. 2013;6(3):52-6.
Kompala T, Shenoi SV, Friedland G. Transmission of tuberculosis in resource-limited settings. Current Hiv/aids Reports. 2013 Sep 1;10(3):264-72.
Hoppe LE, Kettle R, Eisenhut M, Abubakar I; Guideline Development Group. Tuberculosis--diagnosis, management, prevention, and control: summary of updated NICE guidance. BMJ. 2016 Jan 13;352:h6747. doi: 10.1136/bmj.h6747. PMID: 26762607.
Rieder H. Air pollution, COVID-19, and tuberculosis interrelationship. Indian J Tuberc. 2020 Jul;67(3):281-283. doi: 10.1016/j.ijtb.2020.07.033. PMID: 32825853; PMCID: PMC7434498.
Ahmed AE, Yousif N, ELhassan M, Edriss AI, Mudasir Z. Diagnostic perfomance of ziehl-neelsen, flourescent auramine O stains and Genexpert for the detection of mycobacterium tuberculosis. IOSR Journal of Dental and Medical Sciences. 2018 Feb;17(2): 49-55. https://bit.ly/3D5IgcW
Masood R, Muhammad IN, Ali SK, Mushtaque M, Siddiqui T, Khalid F, Ali A. Morbidity rate of drug-susceptible tuberculosis and its medico-economic impact. African Journal of Pharmacy and Pharmacology. 2020 Jul 31;14(6):156-62. doi: 10.5897/AJPP2020.5127
Zumla A, George A, Sharma V, Herbert RH; Baroness Masham of Ilton, Oxley A, Oliver M. The WHO 2014 global tuberculosis report--further to go. Lancet Glob Health. 2015 Jan;3(1):e10-2. doi: 10.1016/S2214-109X(14)70361-4. PMID: 25539957.
Haroon SM, Afzal MS. Latent tuberculosis infection screening in HCV patients: The necessity and guidelines for Pakistan. Asian Pacific Journal of Tropical Disease. 2017;7(4):237-238.
Atif M, Anwar Z, Fatima RK, Malik I, Asghar S, Scahill S. Analysis of tuberculosis treatment outcomes among pulmonary tuberculosis patients in Bahawalpur, Pakistan. BMC Res Notes. 2018 Jun 8;11(1):370. doi: 10.1186/s13104-018-3473-8. PMID: 29884241; PMCID: PMC5994136.
Afzal U, Yusuf A. The state of health in Pakistan: An overview. In the State of Health in Pakistan: An Overview” with Anam Yusuf, paper presented at the Ninth Annual Conference on Management of the Pakistan Economy, Lahore School of Economics. Paper published in the Lahore Journal of Economics: Special Edition. September 1, 2013.
Wright A, Zignol M. Anti-tuberculosis drug resistance in the world: fourth global report: the world health organization/international union against tuberculosis and lung disease (who/union) global project on anti-tuberculosis drug resistance surveillance, 2002-2007. World Health Organization. 2008.
Javaid A. Burden of MDR-TB and its control in Pakistan. Pakistan Journal of Chest Medicine. 2016 Feb 9;21(4):131-133.
Pozniak AL, Coyne KM, Miller RF, Lipman MC, Freedman AR, Ormerod LP, Johnson MA, Collins S, Lucas SB; BHIVA Guidelines Subcommittee. British HIV Association guidelines for the treatment of TB/HIV coinfection 2011. HIV Med. 2011 Oct;12(9):517-24. doi: 10.1111/j.1468-1293.2011.00954.x. PMID: 21951595.
Resende NH, Miranda SS, Ceccato MDGB, Haddad JPA, Reis AMM, Silva DID, Carvalho WDS. Drug therapy problems for patients with tuberculosis and HIV/AIDS at a reference hospital. Einstein (Sao Paulo). 2019 Aug 22;17(4):eAO4696. doi: 10.31744/einstein_journal/2019AO4696. PMID: 31460617; PMCID: PMC6706227.
Dabhi PA, Thangakunam B, Gupta R, James P, Thomas N, Naik D, Christopher DJ. Screening for prevalence of current TB disease and latent TB infection in type 2 diabetes mellitus patients attending a diabetic clinic in an Indian tertiary care hospital. PLoS One. 2020 Jun 5;15(6):e0233385. doi: 10.1371/journal.pone.0233385. PMID: 32502176; PMCID: PMC7274437.
Alavi-Naini R, Sharifi-Mood B, Metanat M. Association between tuberculosis and smoking. Int J High Risk Behav Addict. 2012 Summer;1(2):71-4. doi: 10.5812/ijhrba.5215. Epub 2012 Jul 25. PMID: 24971236; PMCID: PMC4070106.
Jaganath D, Mupere E. Childhood tuberculosis and malnutrition. J Infect Dis. 2012 Dec 15;206(12):1809-15. doi: 10.1093/infdis/jis608. Epub 2012 Oct 2. PMID: 23033147; PMCID: PMC3502375.
Shu CC, Hsu CL, Lee CY, Wang JY, Wu VC, Yang FJ, Wang JT, Yu CJ, Lee LN. Comparison of the Prevalence of Latent Tuberculosis Infection among Non-Dialysis Patients with Severe Chronic Kidney Disease, Patients Receiving Dialysis, and the Dialysis-Unit Staff: A Cross-Sectional Study. PLoS One. 2015 Apr 28;10(4):e0124104. doi: 10.1371/journal.pone.0124104. PMID: 25919813; PMCID: PMC4412816.
Chan ED. Are there common threads in the susceptibility to cancer and tuberculosis? J Thorac Dis. 2020 May;12(5):1776-1780. doi: 10.21037/jtd.2020.03.114. PMID: 32642083; PMCID: PMC7330389.
Konstantinos A. Testing for tuberculosis. Australian Prescriber. 2010;33(1):12-18. doi: 10.18773/austprescr.2010.005.
Wei M, Yongjie Zhao, Zhuoyu Qian, Biao Yang, Xi J, Wei J, Tang B. Pneumonia caused by Mycobacterium tuberculosis. Microbes Infect. 2020 Jul-Aug;22(6-7):278-284. doi: 10.1016/j.micinf.2020.05.020. Epub 2020 Jun 16. PMID: 32561408; PMCID: PMC7297158.
Trunz BB, Fine P, Dye C. Effect of BCG vaccination on childhood tuberculous meningitis and miliary tuberculosis worldwide: a meta-analysis and assessment of cost-effectiveness. Lancet. 2006 Apr 8;367(9517):1173-80. doi: 10.1016/S0140-6736(06)68507-3. PMID: 16616560.
Luca S, Mihaescu T. History of BCG Vaccine. Maedica (Bucur). 2013 Mar;8(1):53-8. PMID: 24023600; PMCID: PMC3749764.
Tripathi KD. Essentials of medical pharmacology. JP Medical Ltd. September 30, 2013.
Haworth CS, Banks J, Capstick T, Fisher AJ, Gorsuch T, Laurenson IF, Leitch A, Loebinger MR, Milburn HJ, Nightingale M, Ormerod P, Shingadia D, Smith D, Whitehead N, Wilson R, Floto RA. British Thoracic Society guidelines for the management of non-tuberculous mycobacterial pulmonary disease (NTM-PD). Thorax. 2017 Nov;72(Suppl 2):ii1-ii64. doi: 10.1136/thoraxjnl-2017-210927. PMID: 29054853.
Alsultan A, Peloquin CA. Therapeutic drug monitoring in the treatment of tuberculosis: an update. Drugs. 2014 Jun;74(8):839-54. doi: 10.1007/s40265-014-0222-8. Erratum in: Drugs. 2014 Jun;74(9):2061. Dosage error in article text. PMID: 24846578.
Horsburgh Jr CR, Barry III CE, Lange C. Treatment of tuberculosis. New England Journal of Medicine. 2015 Nov 26;373(22):2149-2160. doi: 10.1056/NEJMra1413919.
Ali I, Khan J, Khan AU. Need of advance clinical pharmacy services: A case study from Pakistan. Archives of Pharmacy Practice. 2015 Jul 1;6(3). doi: 10.4103/2045 080X.160992.