Appropriateness of Antituberculosis Drug Storage at Patients’ Homes in Raman District, Yala

Abstract

Objective: To assess the appropriateness of antituberculosis (anti-TB) drug storage at home by the patients in terms of storage places, temperature and humidity in the storage places, and to determine patient's knowledge on appropriate drug storage. Methods: The subjects were 60 TB patients registered for treatment at Raman hospital in Yala Province. The researcher visited the patients’ homes in order to observe and interview the patients or their relatives to collect the data on conditions of patients’ home, storage places for anti-TB drugs and their knowledge on drug storage. The study also examined physical characteristics of anti-TB drugs as a sign for degradation and measured temperature and humidity at patients’ homes and storage places, Results: Majority of TB patients (96.67%) lived in isolated houses not sharing the walls with the others. 36.4% of the houses were one-story brick houses. Sixty five percent of the houses had no windows leading to poor ventilation.  Average knowledge score on drug storage was 3.88 ± 1.86 out of 7 points implying the moderate level of knowledge among the patients. The questions with the least correct responses among subjects were "the tablets should be peeled from the foil and kept in the pill box” and “If the prescribed dose is half tablet, the pills should be spited in advance and kept in the pill box" (26.67% of subjects gave the correct answers on both questions). The majority of patients kept their medication within the plastic carrying bags received from the hospital and hung them at the wall (35.00%), kept in the places exposed to the sunlight (46.67%), and kept anti-TB drugs in the places separate from those of other drugs (86.67%). Temperature inside 81.67% of the house and at 90% of storage places were more than 30 degree Celsius. Relative humidity inside 75.00% of the house and 75.00% of drug containers were greater than 60 percent. The study identified discoloration of isoniazid tablets in one subject (1.67%). Only one patients (1.67%) in this study appropriately kept their medications according to the recommendations from the manufacturers i.e., temperature not more than 30 degree Celsius, relative humidity less than 60%, and keeping away from sunlight with one exception for tablets with fixed dose combination of 4 drugs or rifafour e-275 that must be stored at temperatures up to 25 °C. Conclusion: Most patients inappropriately store anti-TB drugs at home. Patients’ knowledge of proper drug storage was approximately half of the full score. Health professionals, especially pharmacists, should be aware of the importance on educating patients or their relatives on appropriate drug storage. More importantly, home visits by a multidisciplinary team should pay attention to patients’ drug storage.