Unmasking the impact of tuberculosis on daily life: a comprehensive observational study on health-related quality of life among patients at a tertiary care hospital.

INTRODUCTION: Tuberculosis (TB) remains a critical global health concern, with India contributing nearly one-fourth of the total global burden. Although significant progress has been made in diagnostic innovations and therapeutic strategies, the rising incidence of multidrug-resistant TB (MDR-TB), coupled with treatment-associated adverse effects, continues to hinder effective disease management. These challenges not only complicate therapeutic outcomes but also pose a substantial threat to global TB elimination efforts. These factors substantially impair health-related quality of life (HRQoL), affecting physical, psychological, social, and environmental domains. Yet, evidence from Indian tertiary care settings using standardized QoL tools remains limited. A holistic assessment that combines clinical, radiological, and microbiological findings with psychological and QoL measures is essential for capturing the full impact of TB on patients' lives.

OBJECTIVE: This study was designed to comprehensively evaluate the QoL among patients with TB by employing the WHOQOL-BREF instrument within a tertiary care hospital setting. Furthermore, it aimed to investigate the influence of key determinants, including sociodemographic characteristics, treatment regimens, therapy-induced adverse events, and drug resistance patterns on QoL across the physical, psychological, social, and environmental domains.

METHODOLOGY: A six-month observational study was performed at a tertiary care hospital, enrolling 220 TB patients aged 20 years and above. QoL was assessed using the WHOQOL-BREF questionnaire, which evaluates four domains: physical, psychological, social, and environmental. Data were collected and analyzed using SPSS version 26, applying descriptive statistical methods to summarize the findings.

RESULTS: The Physical Health domain demonstrated the greatest impairment (mean score: 36.35 ± 5.34), followed by the Psychological (44.49 ± 9.30), Environmental (48.17 ± 9.59), and Social (52.95 ± 19.61) domains. QoL varied significantly across sociodemographic and clinical factors, including education, occupation, and income. While adverse drug reactions (ADRs) were commonly reported, they did not show a significant association with diminished QoL (p > 0.05). Conversely, patients with drug-resistant TB demonstrated markedly lower scores in the environmental domain (p = 0.024) as well as overall QoL (p = 0.001) when compared to individuals with drug-sensitive TB.

CONCLUSION: TB profoundly affects patients' QoL, with the greatest burden observed in the physical and psychological domains. Lower socioeconomic status, limited education, and drug-resistant TB are key determinants of poorer QoL. Incorporating patient-centred care with integrated psychological support alongside routine clinical management may improve overall treatment outcomes and well-being.