title: Effects of Multidrug Resistant Tuberculosis Treatment on Patients' Health Related Quality of Life: Results from a Follow Up Study.
abstract: BACKGROUND
  At present, within the management of multidrug resistant tuberculosis (MDR-TB) much attention is being paid to the traditional microbiological and clinical indicators. Evaluation of the impact of MDR-TB treatment on patients' Health Related Quality of Life (HRQoL) has remained a neglected area.
  
  
  OBJECTIVE
  To evaluate the impact of MDR-TB treatment on patients HRQoL, and determine the predictors of variability in HRQoL along the course of treatment.
  
  
  METHODS
  A prospective follow up study was conducted at the programmatic management unit for drug resistant TB of Lady Reading Hospital Peshawar. Culture confirmed eligible MDR-TB patients were asked to self complete SF-36v2 at the baseline visit, and subsequently after the completion of 12 months of treatment and at the end of treatment. A score of <47 norm-based scoring (NBS) points on component summary measures and health domain scales was considered indicative of function impairment. General linear model repeated measures ANOVA was used examine the change and predictors of change in physical component summary (PCS) and mental component summary (MCS) scores over the time.
  
  
  RESULTS
  A total of 68 out of enrolled 81 eligible MDR-TB patients completed SF-36v2 questionnaire at the three time points. Patients' mean PCS scores at the three time points were, 38.2±4.7, 38.6±4.4 and 42.2±5.2 respectively, and mean MCS were 33.7±7.0, 35.5±6.9 and 40.0±6.9 respectively. Length of sickness prior to the diagnosis of MDR-TB was predictive of difference in PCS scores (F = 4.988, Df = 1, 66), whereas patients' gender (F = 5.638, Df = 1, 66) and length of sickness prior to the diagnosis of MDR-TB (F = 4.400, Df = 1, 66) were predictive of difference in MCS scores.
  
  
  CONCLUSIONS
  Despite the positive impact of MDR-TB treatment on patients' HRQoL, the scores on component summary measures suggested compromised physical and mental health even at the end of treatment. A large multicenter study is suggested to confirm the present findings.
authors.affiliation: Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Pulau Pinang, Malaysia.
authors.forename: Nafees
authors.initials: N
authors.lastname: Ahmad
authors.affiliation: Department of Pulmonology, Postgraduate Medical Institute Peshawar, Peshawar, Pakistan.
authors.forename: Arshad
authors.initials: A
authors.lastname: Javaid
authors.affiliation: Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Pulau Pinang, Malaysia.
authors.forename: Syed Azhar
authors.initials: SA
authors.lastname: Syed Sulaiman
authors.affiliation: Department of Pulmonology, Postgraduate Medical Institute Peshawar, Peshawar, Pakistan.
authors.forename: Anila
authors.initials: A
authors.lastname: Basit
authors.affiliation: PMDT, Lady Reading Hospital Peshawar, Peshawar, Pakistan.
authors.forename: Afsar Khan
authors.initials: AK
authors.lastname: Afridi
authors.affiliation: Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Pulau Pinang, Malaysia.
authors.forename: Ammar Ali Saleh
authors.initials: AA
authors.lastname: Jaber
authors.affiliation: Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Pulau Pinang, Malaysia.
authors.forename: Amer Hayat
authors.initials: AH
authors.lastname: Khan
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D000995:Antitubercular Agents