University of New Mexico College of Pharmacy, Department of Pharmacy Practice and Administrative Sciences, Albuquerque, New Mexico.
University of New Mexico College of Pharmacy, 1 University of New Mexico, MSC09 5360, Albuquerque, NM 87131. E-mail:
Prev Chronic Dis. 2020 Feb 13;17:E14. doi: 10.5888/pcd17.190263.
The objective of this study was to evaluate a novel collaborative care model using community pharmacies as additional access points for latent tuberculosis infection (LTBI) treatment for patients using combination weekly therapy with isoniazid and rifapentine (3HP) plus directly observed therapy for 12 weeks.
This prospective pilot study included adult patients diagnosed with LTBI. Patients were eligible for study participation if they spoke English or Spanish and were followed by the New Mexico Department of Health (NM DOH). Patients were excluded if they were pregnant, receiving concomitant HIV antiretroviral therapy, or had contraindications to 3HP due to allergy or drug interactions. Community pharmacy sites included chain, independent, and hospital outpatient pharmacies in Albuquerque and Santa Fe, New Mexico.
A total of 40 patients initiated treatment with 3HP and were included. Most were female (55%) and had a mean age of 46 years (standard deviation, 12.6 y). A total of 75.0% of patients completed LTBI treatment with 3HP in a community pharmacy site. Individuals of Hispanic ethnicity were more likely to complete treatment (76.7% vs 40.0%, P = .04). Most patients (60%; n = 24) reported experiencing an adverse drug event (ADE) with 3HP therapy. Patients who completed treatment were less likely to experience an ADE than patients who discontinued treatment (50.0% vs 90.0%, P = .03). Pharmacists performed 398 LTBI treatment visits (40 initial visits, 358 follow-up visits), saving the NM DOH approximately 143 hours in patient contact time.
High completion rates and safe administration of LTBI treatment can be achieved in the community pharmacy setting.
本研究的目的是评估一种新的协作护理模式，该模式利用社区药房作为潜伏性结核感染（LTBI）治疗的额外接入点，为使用异烟肼和利福平（3HP）联合每周治疗并接受 12 周直接观察治疗的患者提供服务。
本前瞻性试点研究纳入了被诊断为 LTBI 的成年患者。符合以下条件的患者有资格参加研究：能讲英语或西班牙语，且由新墨西哥州卫生部（NM DOH）负责跟踪随访；患者不能怀孕，不能同时接受 HIV 抗逆转录病毒治疗，或因过敏或药物相互作用而不能使用 3HP；患者不能在妊娠期间、接受同时进行的 HIV 抗逆转录病毒治疗，或因过敏或药物相互作用而不能使用 3HP。社区药房网点包括阿尔伯克基和圣达菲的连锁、独立和医院门诊药房。
共有 40 名患者开始接受 3HP 治疗并被纳入研究。大多数患者为女性（55%），平均年龄为 46 岁（标准差为 12.6 岁）。共有 75.0%的患者在社区药房网点完成了 3HP 治疗。西班牙裔患者更有可能完成治疗（76.7%比 40.0%，P=0.04）。大多数患者（60%；n=24）报告在接受 3HP 治疗时出现了药物不良反应（ADE）。完成治疗的患者发生 ADE 的可能性低于未完成治疗的患者（50.0%比 90.0%，P=0.03）。药剂师进行了 398 次 LTBI 治疗访视（40 次初始访视，358 次随访访视），为 NM DOH 节省了约 143 小时的患者接触时间。
在社区药房环境中，可以实现 LTBI 治疗的高完成率和安全管理。
