Improving Pulmonary Tuberculosis Treatment Outcomes Through Pharmacist-Led Education: Findings From a Malaysian Randomized Control Trial
Author(s)
Rabbiya Ahmad, MPhil1, Amer Hayat Khan, PhD1, Siti Maisharah Sheikh Ghadzi, PhD1, Irfhan Ali Bin Hyder Ali, MBBS2.
1Department of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia, 2Respiratory Clinic, Hospital Pulau Pinang, Penang, Malaysia.
1Department of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia, 2Respiratory Clinic, Hospital Pulau Pinang, Penang, Malaysia.
OBJECTIVES: Tuberculosis (TB) remains a major public health challenge, particularly in low- and middle-income countries. Despite being preventable and curable, poor adherence and treatment outcomes persist. Pharmacist-led interventions may improve TB management, but evidence in Southeast Asia is limited. This study evaluated the effect of structured pharmacist-led education on treatment adherence, cure rates, and sputum conversion among pulmonary TB (PTB) patients in Malaysia.
METHODS: A single-blinded randomized controlled trial was conducted at Hospital Pulau Pinang, Malaysia. A total of 206 PTB patients were randomized into control (standard Directly Observed Therapy [DOT] by nurses) and intervention groups (DOT plus pharmacist-led counseling). The intervention included monthly structured education sessions covering TB knowledge, medication adherence, and lifestyle modifications. Outcomes were assessed at baseline, 2, 4, and 6 months, including treatment completion, cure rates, and sputum conversion time. Statistical analysis used chi-square tests, t-tests, and multivariate logistic regression.
RESULTS: The intervention group had a significantly higher cure rate (56.2% vs. 43.8%, *p* = 0.01) and a non-significantly shorter mean sputum conversion time (2.18 vs. 2.87 months, *p* = 0.7). Treatment completion rates were higher in the control group (67.9% vs. 32.1%, *p* = 0.2). Multivariate analysis showed males (AOR = 2.97, *p* = 0.01) and non-smokers (AOR = 3.62, *p* = 0.02) in the intervention group had better outcomes. Smoking was negatively associated with success in both groups (control AOR = 2.52, *p* = 0.01).
CONCLUSIONS: Pharmacist-led educational interventions improved cure rates and may enhance PTB treatment success, particularly among males and non-smokers. Integrating pharmacists into TB care programs could optimize outcomes in high-burden settings. Further research should explore long-term adherence and cost-effectiveness.
METHODS: A single-blinded randomized controlled trial was conducted at Hospital Pulau Pinang, Malaysia. A total of 206 PTB patients were randomized into control (standard Directly Observed Therapy [DOT] by nurses) and intervention groups (DOT plus pharmacist-led counseling). The intervention included monthly structured education sessions covering TB knowledge, medication adherence, and lifestyle modifications. Outcomes were assessed at baseline, 2, 4, and 6 months, including treatment completion, cure rates, and sputum conversion time. Statistical analysis used chi-square tests, t-tests, and multivariate logistic regression.
RESULTS: The intervention group had a significantly higher cure rate (56.2% vs. 43.8%, *p* = 0.01) and a non-significantly shorter mean sputum conversion time (2.18 vs. 2.87 months, *p* = 0.7). Treatment completion rates were higher in the control group (67.9% vs. 32.1%, *p* = 0.2). Multivariate analysis showed males (AOR = 2.97, *p* = 0.01) and non-smokers (AOR = 3.62, *p* = 0.02) in the intervention group had better outcomes. Smoking was negatively associated with success in both groups (control AOR = 2.52, *p* = 0.01).
CONCLUSIONS: Pharmacist-led educational interventions improved cure rates and may enhance PTB treatment success, particularly among males and non-smokers. Integrating pharmacists into TB care programs could optimize outcomes in high-burden settings. Further research should explore long-term adherence and cost-effectiveness.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
CO147
Topic
Clinical Outcomes, Health Service Delivery & Process of Care, Patient-Centered Research
Topic Subcategory
Clinical Outcomes Assessment
Disease
Infectious Disease (non-vaccine), Mental Health (including addition), No Additional Disease & Conditions/Specialized Treatment Areas, Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)