Health related quality of life and associated factors with medication adherence among tuberculosis patients in selected districts of Gandaki Province of Nepal

Abstract

Background Tuberculosis is one of the significant public health problems of Nepal. Adherence to medication is very important for improving quality of life and preventing complication. Adherence to tuberculosis medications has significant economic and therapeutic consequences as non-adherence patients are at greater risk of developing complications which affect their health status and overall quality of life. The study aims to determine the factors associated with medication adherence and its effect on health related quality of life among tuberculosis patients in selected districts of Gandaki Province. Methods A health facility based cross-sectional study was carried out among 180 tuberculosis patients registered under DOTS and receiving treatment more than or equal to 60 days. WHOQOL-BREF tools to assess quality of life and Morisky medication adherence scale (MMAS-8) was adopt to assess medication adherence. Data was entered in Epi-data and analysis was performed with the help of the Statistical Package for Social Science (SPSS). The odds ratio with a 95% CI was calculated and p-value of <0.05 was considered as cutoff for statistical significance. Results A total 180 TB patients were participated in this study. Overall quality of life ranges from 10.75 to 89.25 with Mean ± SD as 55.96 ± 14.65. More than three-fourth (79.4%) respondents were adhere to medication. Medication adherence and health related quality of life was found statistically significant with relationship with health workers, favourable time at DOTS centre, absence of co-infection. Participants who were highly adhered to medication had good quality of life. Conclusion Majority of tuberculosis patients adhering to medication had good quality of life. Especial emphasis should be given to tuberculosis patients with co-infection, health workers should behave friendly and provide appropriate counselling in order to maintain the medication adherence and quality of life.

Health-related quality of life of persons living with tuberculosis: A cross-sectional study

“…The observation in this study that female sex, being married, having higher education and having high income were associated with better Environmental HRQoL was comparable to studies conducted in Nepal and Indonesia [22] , [29] . The results suggest that access to higher formal education as well as employment with income may contribute to better environmental conditions for persons with TB.…”

“…This study investigated the HRQoL of persons living with TB in the Greater Accra Region of Ghana using a globally validated and reliable instrument (WHOQoL-BREF). The WHOQoL-BREF tool was used in this study because it is an internationally accepted and reliable instrument which has been used to assess the HRQoL of persons living with health conditions which impact their quality of life [2] , [6] , [8] , [18] , [29] . The findings can therefore be considered in relation to other persons living with health conditions (such as TB) within comparable settings as Greater Accra, Ghana.…”

“…Importantly, persons living with TB who either have low levels of education, are unemployed or have been diagnosed with extrapulmonary TB could be supported to garner adequate social support to elevate their Social Relationship HRQoL. Religion facilitates social networks and has the potential to contribute to the social well-being of persons living with chronic conditions like TB [29] . It was therefore interesting to observe in this study that in Ghana, a country described as the most religious in the world [5] , the religious affiliation of persons living with TB neither influenced their Social relationship nor other HRQoL domains.…”

“…Despite the availability of treatment, TB can have deleterious consequences on the physical, psychological, social and environmental health-related quality of life (HRQoL) of persons living with TB [3] , [10] , [21] , [29] . Quality of life refers to “individuals’ perceptions of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns” [25] .…”

“…The high prevalence of TB in a COVID-19 pandemic era implies that healthcare providers will need to continue providing holistic care which addresses the HRQoL needs of persons living with TB who are under their care. Previous studies in Iran, India, Pakistan, Nepal and Ethiopia have examined the HRQoL of persons living with TB and how they are influenced by patients’ sociodemographic characteristics such as sex, site of TB infection, level of education and income [3] , [10] , [21] , [29] . However, there is a paucity of research which have investigated the physical, psychological, social relationship and environmental HRQoL of persons living with TB and its related factors within resource-limited African settings like Ghana.…”