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.