Impact of adverse drug reaction on quality of life in drug resistant tuberculosis

Background: India has largest population of drug resistant tuberculosis, the treatment of which is long and full of adverse drug reactions. Despite the ongoing research in clinical and pharmacological aspects, quality of life in drug-resistant tuberculosis remains less explored. This study aims to study the quality of life in drug-resistant tuberculosis patients before and after treatment of the adverse drug reactions. Methods: This hospital based cross-sectional study done in the at tertiary care center in Surat, from January 2019 to February 2020, enrolling patients above 18 years, with multi-drug/ extensively drug resistant tuberculosis, who suffered > 1 adverse drug reaction after commencing treatment. SF-36 was administered at start of treatment and after treatment of first adverse drug reaction, and scores compared. Paired Student T Test was used for comparison of pre - post scores. p -value < 0.05 is considered statistically significant. Results: Among the 120 patients studied, majority (87.5%) were had pulmonary tuberculosis. 92.5% and 7.2% were multi-drug resistant and extensively drug resistant respectively. A significant improvement in QOL scores was seen in all 3 domains post treatment of adverse drug reaction- physical domain: After vs. Before: 55.2±6.8 vs. 25.2±4.2; (p-value < 0.0001), mental domain: After vs. Before: 66.8±6.7 vs. 39.4±2.1; (p-value < 0.0001) and social domain After vs. Before: 65.4±5.5 vs. 39.7±2.0; p-value < 0.0001). Conclusions: Drug-resistant tuberculosis along with its associated adverse drug reactions greatly impacts the quality of life in all domains. However, prevention and effective treatment of such adverse effects, especially in systematic protocolised manner can do wonders in improving the life of these patients.