Impact of tuberculosis treatment on health-related quality of life of pulmonary tuberculosis patients: a follow-up study

Abstract

BackgroundAt present, much of the attention within tuberculosis (TB) management is spent on microbiological cure, and its impact on health-related quality of life (HRQoL) is either undervalued or seldom considered. The aim of this study was to evaluate the impact of TB treatment on HRQoL of new smear positive pulmonary tuberculosis (PTB) patients. Moreover, we also aimed to determine whether the selected socio-demographic and clinical variables were predictive of variability in the HRQoL scores over time.MethodsThis was a prospective follow-up of new smear positive PTB patients who were diagnosed at the chest clinic of Penang General Hospital between March 2010 and February 2011. All eligible patients (i.e., a new case of smear positive PTB, literate and aged 18 years or above) were asked to self-complete the SF-36v2 questionnaire at the start of their treatment, and then subsequently after the intensive phase and at the end of the treatment. A score on a health domain or component summary measure that was less than 47 norm-based scoring (NBS) point was considered indicative of impaired function within that health domain or dimension. Likewise, an individual having mental component summary (MCS) score ≤ 42 NBS point was considered to be at the risk of depression. Repeated measures ANOVA test was performed to examine how the summary scores varied over time, and to determine whether independent variables were predictive of variability in the physical component summary (PCS) and MCS scores over time.ResultsA total of 216 patients completed the SF-36v2 questionnaire at the start of their treatment. Out of these, 177 and 153 completed the questionnaire at the second and third follow-ups, respectively. The mean PCS scores at the start of the treatment, after the intensive phase and at the end of treatment were 41.9 (SD 5.1), 45.8 (SD 4.8) and 46.0 (SD 6.9), respectively. Similarly, the mean MCS scores at the start of the treatment, after the intensive phase and at the end of the treatment were 39.9 (SD 7.3), 45.0 (SD 6.8) and 46.8 (SD 7.8), respectively. More than 23% of the patients were at the risk of depression at the end of their TB treatment. Patient’s age and being a smoker were predictive of differences in the PCS scores. Similarly, monthly income, being a smoker and TB-related symptoms at the start of the treatment were predictive of differences in the MCS scores.ConclusionAlthough HRQoL improved with the treatment, the scores on component summary measures showed compromised physical and mental health among study patients even at the end of their TB treatment.

A Study on Assessment of Patients Health Related Quality of Life During Tuberculosis Treatment in a Tertiary Care Teaching Hospital

“…Similarity was observed in study of Atif M with more male patient. 16 Contrary to this, a study by Marra et al showed more female patient. 17 Fifty one percent of patients were in age group of 20-39, 31.43 percent were in the age group of 40-59 and 17.14 percent were in age group 60-79.…”

“…Similarly, the mean MCS scores at the start of the treatment, after the intensive phase and at the end of the treatment were 39.9 ± 7.3, 45.0 ± 6.8 and 46.8 ± 7.8, respectively. 16 Marra and associates reported that compared with the U.S. general population norms, patients with active TB had worse scores on the SF-36 scales at the end of the treatment 17 compared to latent TB. A few other studies also reported almost similar findings.…”

Health Status and Quality of Life in Tuberculosis: Systematic Review of Study Design, Instruments, Measuring Properties and Outcomes

“…All these articles were published in English. The data was based on comparative studies of TB population from China , two from Malaysia [18,23], five from India [14,15,29,[35][36][37][38], four from Canada [5,24,25,30] one form each UK [17] Pakistan [35], Spain [36] Taiwan [28] South Africa [37] and Turkey [39]. Among the selected articles fourteen studies were cross sectional [5,14,26,27,30,33,[34][35][36][37][38][39][40] and sixteen were prospective cohort based studies [15][16][17][18][19][20][21][22][23][24][25][26]29,31,32,41].…”

“…Generic instrument measures were used in 10 studies with different language versions of SF-36 [5,[16][17][18][19][20]24,25,38,40,41]. SF-36 is a generic health outcomes measure consisting of 36 items aggregated into eight sub-scales of PF (physical functioning), RP (role physical), BP (body pain), GH (general health), VT (vitality), SF (social functioning), RE (role emotion) and MH (mental health) [43].…”

Prediction Model for Health-Related Quality of Life in Hospitalized Patients with Pulmonary Tuberculosis

“…만성질환자의 삶의 질 설명에 가장 널리 적용되는 [9] Wilson과 Cleary의 삶의 질 수정모형 [10]은 생물 학적 요인, 증상, 기능적 상태, 전반적 건강 인식이 삶의 질을 설명하 는 것이 주된 맥락이면서, 이 모든 요인이 환자의 개인적, 환경적 특 성과도 연결되어 있는 다층구조이다 [10]. 하지만 만성질환자들의 삶 의 질의 포괄성 및 다차원 요인의 복잡성에도 불구하고 폐결핵환자 를 대상으로 한 삶의 질 연구는 주로 선택적 관심 변수와 삶의 질과 의 관계 탐색에 그치고 있다 [11][12][13][14]. 이들 선행연구에서 확인된 요인 에는 학력 및 소득과 같은 사회경제적 특성, 질환으로 인한 생리적 증상 및 기능, 주관적 건강인식이 있으며 [12] 우울은 삶의 질에 부정 적 방향으로 영향을 미치는 것으로 확인되었다 [14].…”