Standardised patient study to assess tuberculosis case detection within the private pharmacy sector in Vietnam
| Autor: | Nhung Nguyen Viet, Shannon McKinn, Ben J. Marais, Hoang Huy Tran, Stephen Jan, Thu Anh Nguyen, Tan Luong Minh, Shukry Zawahir, Justin Beardsley, Thanh Nguyen Trung, Son Nguyen Tu, Ha Nguyen Viet, Guy B. Marks, Thai Cao Hung, Van Nguyen Thi Cam, Anh Dang Duc, Kerri Viney, Gregory J. Fox, Sarah Bernays, Joel Negin, Kavindhran Velen, Hien Thi Thu Le, Hung Tran Thi Mai |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
pharmacy
medicine.medical_specialty Tuberculosis Referral Cross-sectional study case detection standardised patient survey Pharmacy other study design 1117 Public Health and Health Services Tuberculosis diagnosis Medicine Humans Medical prescription 11 Medical and Health Sciences Original Research Pharmacies business.industry Health Policy public health Public Health Environmental and Occupational Health Health services research medicine.disease health services research Cross-Sectional Studies Vietnam tuberculosis Family medicine Private healthcare business |
| Zdroj: | BMJ Global Health |
| ISSN: | 2059-7908 |
| Popis: | BackgroundOf the estimated 10 million people affected by (TB) each year, one-third are never diagnosed. Delayed case detection within the private healthcare sector has been identified as a particular problem in some settings, leading to considerable morbidity, mortality and community transmission. Using unannounced standardised patient (SP) visits to the pharmacies, we aimed to evaluate the performance of private pharmacies in the detection and treatment of TB.MethodsA cross-sectional study was undertaken at randomly selected private pharmacies within 40 districts of Vietnam. Trained actors implemented two standardised clinical scenarios of presumptive TB and presumptive multidrug-resistant TB (MDR-TB). Outcomes were the proportion of SPs referred for medical assessment and the proportion inappropriately receiving broad-spectrum antibiotics. Logistic regression evaluated predictors of SPs’ referral.ResultsIn total, 638 SP encounters were conducted, of which only 155 (24.3%) were referred for medical assessment; 511 (80·1%) were inappropriately offered antibiotics. A higher proportion of SPs were referred without having been given antibiotics if they had presumptive MDR-TB (68/320, 21.3%) versus presumptive TB (17/318, 5.3%; adjusted OR=4.8, 95% CI 2.9 to 7.8). Pharmacies offered antibiotics without a prescription to 89.9% of SPs with presumptive TB and 70.3% with presumptive MDR-TB, with no clear follow-up plan.ConclusionsFew SPs with presumptive TB were appropriately referred for medical assessment by private pharmacies. Interventions to improve appropriate TB referral within the private pharmacy sector are urgently required to reduce the number of undiagnosed TB cases in Vietnam and similar high-prevalence settings. |
| Databáze: | OpenAIRE |
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