Antibiotics dispensing in tuberculosis patients using standardized patient approach: Results from a cross-sectional study from community pharmacies in Punjab, Pakistan

Title : Antibiotics dispensing in tuberculosis patients using standardized patient approach: Results from a cross-sectional study from community pharmacies in Punjab, Pakistan

Abstract:

Background: Pakistan ranks 6th globally in antibiotic consumption, with patients frequently obtaining medications directly from community pharmacies. Our objective was to evaluate the medicine distribution behaviors of pharmacies for assumed and confirmed tuberculosis utilizing the standardized patient technique in Pakistan.

Methods: In this cross-sectional study, we adopted two standardized patient cases in pharmacies of three cities of Punjab. The first case involved a presumed tuberculosis patient presenting with 2–3 weeks of cough and fever (Case-1), and the second case involved a confirmed tuberculosis patient carrying microbiologically confirmed tuberculosis results (Case-2). The ideal management for Cases-1 and Case-2 is referral of standardized patients to a healthcare provider without dispensing antibiotics or steroids, or both. The differences in antibiotic use, steroid use, and the number of medicines dispensed in referred and non-referred patients between Case-1 and Case-2 were analyzed using descriptive statistics.

Results: Between April 1, 2020, and July 31, 2020, standardized patients completed 575 out of 598 interactions among community pharmacies in Lahore, Rawalpindi, and Sialkot. We recorded ideal management in 115 (37.7%) of the 305 Case-1 interactions and 130 (48.1%) of the 270 Case-2 interactions. Antibiotic dispensing was higher in Case-1, with 71 out of 305 instances (23.3%), than in Case-2 interactions, with 27 out of 270 instances (10.0%). Anti-tuberculosis drugs were dispensed to 1 patient in Case-1 (0.3%) and to 19 patients (7.0%) in Case-2.

Conclusion: Just over one-third of pharmacies in Punjab, Pakistan, effectively managed patients with suspected tuberculosis, while almost half successfully managed cases with proven tuberculosis. The existence of a proven diagnosis marginally alters the conduct in the appropriate management of patients.

Biography:

Dr Ali Hassan Gillani has completed his PhD from Xi’an Jiaotong University in Pharmacy administration and clinical pharmacy. His work specialization lies in the domain of Health Policy with the special interest to Antibiotics management in the different healthcare settings. He has been able to publish more than 65 research articles (Both as first and co-authors) and working in collaboration with global researchers from Qatar University, University of Mississippi, The University of West Indies, University of Ajman, University of Huddersfield and King Faisal University Saudi Arabia.