title: Impact of connecting tuberculosis directly observed therapy short-course with smoking cessation on health-related quality of life.
abstract: BACKGROUND
  With evolving evidence of association between tuberculosis (TB) and tobacco smoking, recommendations for the inclusion of tobacco cessation interventions in TB care are becoming increasingly important and more widely disseminated. Connecting TB and tobacco cessation interventions has been strongly advocated as this may yield better outcomes. However, no study has documented the impact of such connection on health-related quality of life (HRQoL). The objective of this study was to document the impact of an integrated TB directly observed therapy short-course (DOTS) plus smoking cessation intervention (SCI) on HRQoL.
  
  
  METHODS
  This was a multi-centered non-randomized controlled study involving 120 TB patients who were current smokers at the time of TB diagnosis in Malaysia. Patients were assigned to either of two groups: the usual TB-DOTS plus SCI (SCIDOTS group) or the usual TB-DOTS only (DOTS group). The effect of the novel strategy on HRQoL was measured using EQ-5D questionnaire. Two-way repeated measure ANOVA was used to examine the effects.
  
  
  RESULTS
  When compared, participants who received the integrated intervention had a better HRQoL than those who received the usual TB care. The SCIDOTS group had a significantly greater increase in EQ-5D utility score than the DOTS group during 6 months follow-up (mean ± SD = 0.98 ± 0.08 vs. 0.91 ± 0.14, p = 0.006). Similarly, the mean scores for EQ-VAS showed a consistently similar trend as the EQ-5D indices, with the scores increasing over the course of TB treatment. Furthermore, for the EQ-VAS, there were significant main effects for group [F (1, 84) = 4.91, p = 0.029, η2 = 0.06], time [F (2, 168) = 139.50, p = < 0.001, η2 = 0.62] and group x time interaction [F (2, 168) = 13.89, p = < 0.001, η2 = 0.14].
  
  
  CONCLUSIONS
  This study supports the evidence that an integrated TB-tobacco treatment strategy could potentially improve overall quality of life outcomes among TB patients who are smokers.
authors.affiliation: College of Pharmacy, Qatar University, P,O, Box 2713, Doha, Qatar. aawaisu@qu.edu.qa.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Awaisu
authors.forename: Mohamad
authors.initials: M
authors.lastname: Haniki Nik Mohamed
authors.forename: Noorliza Mohamad
authors.initials: NM
authors.lastname: Noordin
authors.forename: Abdul Razak
authors.initials: AR
authors.lastname: Muttalif
authors.forename: Noorizan Abd
authors.initials: NA
authors.lastname: Aziz
authors.forename: Syed Azhar
authors.initials: SA
authors.lastname: Syed Sulaiman
authors.forename: Aziah Ahmad
authors.initials: AA
authors.lastname: Mahayiddin