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Clinical pharmacy and clinical trials (including case series)
Pharmacist's role in the treatment of patients with tuberculosis ñ our positive experience
  1. J. Toni,
  2. N. Cebron Lipovec,
  3. P. Svetina Sorli,
  4. M. Kosnik
  1. 1University Clinic of Respiratory and Allergic Diseases Golnik Pharmacy Golnik, Slovenia
  2. 2University Clinic of Respiratory and Allergic Diseases Golnik, Tuberculosis, Golnik, Slovenia

Abstract

Background Tuberculosis as a disease which demands long-term multidrug treatment, which can cause serious adverse drug reactions that can affect the course of therapy. Moreover, antituberculotic drugs interact with a variety of drugs, OTC preparations and food, all of which can significantly alter the effectiveness of patient's therapy. Patient's compliance and patient-tailored therapy are thus crucial for achieving effective treatment. In the University Clinic Golnik, clinical pharmacists are included in the treatment of patients with tuberculosis. They perform patient counselling on correct drug use, management of possible adverse drug events and drug therapy reviews. These most frequently include counselling on clinically important drug-drug interactions.

Purpose Improving the quality of care for patients with tuberculosis with focus on drug-drug interactions.

Materials and methods Data was collected from clinical pharmacist reports and other relevant clinical data. Drug interactions were checked by at least two distinct drug interactions databases and interpreted by clinical pharmacist for each patient individually. Clinical importance was defined as possible drug effect change that required either detailed drug effectiveness monitoring, dose adjustment, dosing regime adjustment or additional laboratory tests performed.

Results From June to September 2011 clinical pharmacists performed 44 drug therapy reviews in 32 patients on the tuberculosis department. In 46,9% cases (15/32) at least one clinical important drug-drug interaction was observed, mostly with warfarin, calcium, levothyroxine and methadone.

The detected interactions and adjusted therapy were documented in the hospital electronic clinical files as well as in the patients' discharge documentation. This allowed the patient's GP and local pulmonologist to be informed about the therapy adjustments and the need for readjustments at the end of antituberculotic treatment.

Conclusions The collaboration of different healthcare professional in the healthcare team at the University Clinic Golnik aims at ensuring high quality patient care. At the tuberculosis department, clinical pharmacists counsel to patients and advise on the management of clinically important interactions on a daily basis and thus constantly improve the high quality of patient care.

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