Evaluation of a pharmacist-led multidisciplinary approach to the treatment of latent tuberculosis in refugee patients in the primary care setting

J Am Pharm Assoc (2003). 2024 Nov-Dec;64(6):102246. doi: 10.1016/j.japh.2024.102246. Epub 2024 Sep 12.

Abstract

Background: Treatment of latent tuberculosis infection (LTBI) is essential for refugee patients who have been relocated to the United States to prevent progression to active infection.

Objective: This study aimed to determine the effectiveness of a multidisciplinary team approach, embedded within a primary care clinic, to treatment of LTBI in newly resettled refugee patients compared with a local health department.

Methods: This was a single-center, retrospective chart review of newly resettled refugee patients 18-89 years old with a diagnosis of LTBI. The primary objective was completion rate of LTBI therapy within 1 year of resettlement. Secondary objectives were incidence of adverse events, regimen switches, and adherence rate.

Results: A total of 58 patients were included in the study: 14 individuals through the multidisciplinary clinic and 44 individuals with the local health department. Completion of therapy within 1 year of resettlement was seen in 71.4% of patients (n = 10) in the multidisciplinary clinic compared with 72.7% (n = 32) at the health department. There were 7 patients who underwent a regimen switch, all of whom were in the health department arm. Adverse effects occurred in 14.2% of patients in the multidisciplinary clinic and 15.9% of patients in the health department arm. Treatment adherence was 98.6% in the multidisciplinary clinic and 90.5% in the local health department arm.

Conclusion: Use of a multidisciplinary team was successful in completion of LTBI treatment in refugee patients, helping to alleviate barriers to treatment completion by ensuring adherence and close follow-up.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antitubercular Agents* / administration & dosage
  • Antitubercular Agents* / adverse effects
  • Antitubercular Agents* / therapeutic use
  • Female
  • Humans
  • Latent Tuberculosis* / diagnosis
  • Latent Tuberculosis* / drug therapy
  • Male
  • Medication Adherence
  • Middle Aged
  • Patient Care Team* / organization & administration
  • Pharmacists* / organization & administration
  • Primary Health Care*
  • Professional Role
  • Refugees*
  • Retrospective Studies
  • United States
  • Young Adult

Substances

  • Antitubercular Agents