Effectiveness, challenges, and improvement strategies for active tuberculosis case-finding practices by community pharmacy personnel: A scoping review.

BACKGROUND: Tuberculosis (TB) remains a major health challenge, with delayed detection accelerating its spread. Pharmacies are often the first contact for individuals with TB symptoms, yet their role in active case finding is underutilized.

OBJECTIVE: This scoping review aims to comprehensively map the current studies, challenges, and potential strategies for effective and sustainable implementation.

METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews guidelines, we searched PubMed and Scopus for relevant studies up to October 26, 2023. We included studies on community pharmacy personnel (PP) engaged in active TB case-finding. Outcomes covered effectiveness, challenges, and potential strategies for active TB case finding involving PP. Two reviewers independently screened and extracted data, which were synthesized using the Consolidated Framework for Implementation Research.

RESULTS: Twelve of 2003 articles met the inclusion criteria. All studies showed a contribution to TB case finding. However, key challenges identified include the complexity of integrating TB case-detection into routine workflows, patients' access barriers to clinics, and lack of resources. PP also faced issues such as their lack of confidence in TB screening and inadequate knowledge regarding TB referral. Improvement strategies are electronic referral, capacity building for PP, free diagnostic services, incentives for PP, and improved coordination between PP and TB program staff.

CONCLUSION: Enhancing active TB case detection by PP requires addressing challenges in workflow integration, patient access, and resource limitations. Capacity building, electronic referrals, free diagnostics, and incentives are key strategies to support PP involvement. Strengthening collaboration between the PP and TB program staff is essential for effective and sustainable referral processes.