Published: 2019-07-24

Assessment of medication adherence, quality of life and risk factors among patients with tuberculosis in a South Indian tertiary care hospital: a cross-sectional study

Shaik Salma, Abdul Amreen Siddiqua, R. S. S. Lakshmi Keerthana, Meghana Suryadevara, Dhadala Victor Prabhakar, Ravindrababu Pingili


Background: The main objective of the current study was to assess the level of medication adherence, quality of life, risk factors for better treatment outcomes and to improve patient quality of life by giving TB education.

Methods: A prospective observational study was conducted on 278 patients (139 tubercular patients and 139 health volunteers). A data collection form of various socio-demographic factors, lifestyle factors, and co-morbid conditions for tuberculosis were collected. The quality of life (QOL) was assessed by interviewing the subjects using WHO-QOL BREF questionnaire. Morisky – 8 item medication Adherence Questionnaire was used for assessing adherence.  

Results: In a total of 139 TB patients, high adherence (60.06%), medium adherence (20.86%) and low adherence (10.07%) are reported. WHOQOL-BREF mean domain scores were physical health (54.10±12.33), psychological health (51.73±16.24), social health (62.04±15.35) and environmental health (57.14±16.90) respectively. In present study male (67.63%) are higher than females (32.37%). Risk factors observed in study were statistically significant and discussed in present study.

Conclusions: This study showed that the MMAS-8 had good reliability and validity for measuring adherence levels in rural TB patients. There was a high level of adherence to anti-TB treatment was seen in study area. WHO-QOL BREF questionnaire had good reliability and validity for measuring quality of life and Improved quality of life observed in patients with high adherence to anti tubercular drugs. Risk factors such as age, education, locality, food habits, income, smoking and alcoholism are independently associated with Tuberculosis.


Tuberculosis, Quality of life, Adherence, Risk factors

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Global TB Report 2017, WHO, 2017.

India on the right path to ending TB, World Health Organization, 2016.

Akosua AA, Richard OA. Tuberculosis - an overview. J Public Health Emerg. 2017;1(7):1-11.

Ji Yeon Lee. Diagnosis and Treatment of Extra pulmonary Tuberculosis. Tuberc Respir Dis (Seoul). 2015;78(2):47–55.

Minlan X, Urban M, Juncheng L and Lingzhong X. Detection of Low Adherence in Rural Tuberculosis Patients in China: Application of Morisky Medication Adherence Scale. Int J Environ Res Public Health. 2017;14:248.

Elsa Z, Adriana G, Silvia E, Mario C , Carlos C, Soledad B. Risk Factors Associated With Tuberculosis Mortality In Adults In Six Provinces Of Argentina, medicina (buenos aires). 2017;77:267-73.

Szabo S. The World Health Organization Quality of Life (WHOQOL) assessment instrument.In Quality of life and pharmacoeconomics in clinical trials. Spilker B (ed). Philadelphia PA: Lippincott-Raven; 1996: 355–362.

Chamla D. The assessment of patients’ health-related quality of life during tuberculosis treatment in Wuhan, China. Int J Tuberc Lung Dis. 2004;8(9):1100–6.

Mohrana PR, Statapathy DM, Sahani NC, Behera TR, Jena D, Tripathi RM. An analysis of treatment outcome among tuberculosis patients put under DOTS at tertiary level health facvility of Orrisa. J Community Med. 2009;5(2).

Smith GS, Van Den Eeden SK, Baxter R, Shan J, Van Rie A, Herring AH, et al. Cigarette smoking and pulmonary tuberculosis in northern California. J Epidemiol Community Health. 2015;69(6):568-73.

Wei-Sheng C, Yu-Ling L, Ming-chin Y. Psychometric testing of the short version of the world health organization quality of life (WHOQOL-BREF) questionnaire among pulmonary tuberculosis patients in Taiwan. BMC Public Health. 2012;12(1):630-2.

Sule AB, Loius OO, Kolawole MA, Baba AI, Razak OS, Anthony IJ, et al. Quality Of Life Of Patients With Tuberculosis In A Nigerian Teaching Hospital. Turkish J Family Med Primary Care. 2014;8(2):39-47.

Gube AA, Megbaru D, Kalid S, Bisete K, Mengesha A, Zeynu A, et al. Assessment of Anti-TB Drug Nonadherence and Associated Factors among TB Patients Attending TB Clinics in Arba Minch Governmental Health Institutions, Southern Ethiopia. Tuberculosis Res Treatment. 2018:7.