The impact of direct observed therapy on daily living activities, quality of life and socioeconomic burden on patients with tuberculosis in primary care in Singapore

Introduction: The prevalence of tuberculosis (TB) is rising in Singapore. The affected patients are provided with free directly observed therapy (DOT) at local polyclinics. The impact of DOT on their daily living activities (DLA) and quality of life (QOL) may affect their treatment adherence. The st...

Full description

Bibliographic Details
Main Authors: Hwee Khim Lee, Stephanie Swee Hong Teo, Sylvaine Barbier, Siew Cheng Tang, Guat Hoon Yeo, Ngiap Chuan Tan
Format: Article
Language:English
Published: SAGE Publishing 2016-12-01
Series:Proceedings of Singapore Healthcare
Online Access:https://doi.org/10.1177/2010105816652148
_version_ 1819100101334794240
author Hwee Khim Lee
Stephanie Swee Hong Teo
Sylvaine Barbier
Siew Cheng Tang
Guat Hoon Yeo
Ngiap Chuan Tan
author_facet Hwee Khim Lee
Stephanie Swee Hong Teo
Sylvaine Barbier
Siew Cheng Tang
Guat Hoon Yeo
Ngiap Chuan Tan
author_sort Hwee Khim Lee
collection DOAJ
description Introduction: The prevalence of tuberculosis (TB) is rising in Singapore. The affected patients are provided with free directly observed therapy (DOT) at local polyclinics. The impact of DOT on their daily living activities (DLA) and quality of life (QOL) may affect their treatment adherence. The study aimed to evaluate the effect of DOT on the DLA and QOL of patients with TB and to quantify their socioeconomic burden. Material and methods: This questionnaire survey recruited adult multi-ethnic Asian patients with TB who were on DOT at nine local polyclinics. The questionnaire collected data on their demographic characteristics and DLA, anti-TB medications, the validated WHOQOL-BREF instrument, and socioeconomic costs. The associations between DOT and independent variables were tested using Student’s t -test and ANOVA. Results: The 356 patients recruited comprised 63% males with mean age of 43 years; 73% of them were employed, 73% reported increased travel time (mean 41 minutes/DOT visit) and DOT-related cost (mean S$260–S$389 for 6–9 months’ treatment); 47% indicated reduced participation in social functions and 45% felt that DOT had caused disruptions to their work, especially among younger patients. The WHOQOL-BREF scores were 13.3/20 “Physical Health”, 12.6/20 “Psychological”, 13.4/20 “Social Relationships” and 12.3/20 “Environment” domains, respectively. Some 52% of them rated their QOL as “good” or “very good”, 47% reported satisfaction with their health but 74% experienced negative feelings such as despair, anxiety and depression. Conclusion: The DOT affected patients’ DLA, QOL and increased their socioeconomic burden, which should be addressed by appropriate mitigating measures in the community.
first_indexed 2024-12-22T00:57:25Z
format Article
id doaj.art-580233262b5a4adf9c03a0decc35a71c
institution Directory Open Access Journal
issn 2010-1058
2059-2329
language English
last_indexed 2024-12-22T00:57:25Z
publishDate 2016-12-01
publisher SAGE Publishing
record_format Article
series Proceedings of Singapore Healthcare
spelling doaj.art-580233262b5a4adf9c03a0decc35a71c2022-12-21T18:44:16ZengSAGE PublishingProceedings of Singapore Healthcare2010-10582059-23292016-12-012510.1177/2010105816652148The impact of direct observed therapy on daily living activities, quality of life and socioeconomic burden on patients with tuberculosis in primary care in SingaporeHwee Khim Lee0Stephanie Swee Hong Teo1Sylvaine Barbier2Siew Cheng Tang3Guat Hoon Yeo4Ngiap Chuan Tan5SingHealth Polyclinic-Outram, SingaporeDepartment of Nursing, SingHealth Polyclinics, SingaporeA*STAR - Agency for Science, Technology and Research, SingaporeDepartment of Nursing, SingHealth Polyclinics, SingaporeDepartment of Nursing, SingHealth Polyclinics, SingaporeSHP-Research, SingHealth Polyclinics, Adjunct Assistant Professor, DUKE-NUS Graduate Medical School, SingaporeIntroduction: The prevalence of tuberculosis (TB) is rising in Singapore. The affected patients are provided with free directly observed therapy (DOT) at local polyclinics. The impact of DOT on their daily living activities (DLA) and quality of life (QOL) may affect their treatment adherence. The study aimed to evaluate the effect of DOT on the DLA and QOL of patients with TB and to quantify their socioeconomic burden. Material and methods: This questionnaire survey recruited adult multi-ethnic Asian patients with TB who were on DOT at nine local polyclinics. The questionnaire collected data on their demographic characteristics and DLA, anti-TB medications, the validated WHOQOL-BREF instrument, and socioeconomic costs. The associations between DOT and independent variables were tested using Student’s t -test and ANOVA. Results: The 356 patients recruited comprised 63% males with mean age of 43 years; 73% of them were employed, 73% reported increased travel time (mean 41 minutes/DOT visit) and DOT-related cost (mean S$260–S$389 for 6–9 months’ treatment); 47% indicated reduced participation in social functions and 45% felt that DOT had caused disruptions to their work, especially among younger patients. The WHOQOL-BREF scores were 13.3/20 “Physical Health”, 12.6/20 “Psychological”, 13.4/20 “Social Relationships” and 12.3/20 “Environment” domains, respectively. Some 52% of them rated their QOL as “good” or “very good”, 47% reported satisfaction with their health but 74% experienced negative feelings such as despair, anxiety and depression. Conclusion: The DOT affected patients’ DLA, QOL and increased their socioeconomic burden, which should be addressed by appropriate mitigating measures in the community.https://doi.org/10.1177/2010105816652148
spellingShingle Hwee Khim Lee
Stephanie Swee Hong Teo
Sylvaine Barbier
Siew Cheng Tang
Guat Hoon Yeo
Ngiap Chuan Tan
The impact of direct observed therapy on daily living activities, quality of life and socioeconomic burden on patients with tuberculosis in primary care in Singapore
Proceedings of Singapore Healthcare
title The impact of direct observed therapy on daily living activities, quality of life and socioeconomic burden on patients with tuberculosis in primary care in Singapore
title_full The impact of direct observed therapy on daily living activities, quality of life and socioeconomic burden on patients with tuberculosis in primary care in Singapore
title_fullStr The impact of direct observed therapy on daily living activities, quality of life and socioeconomic burden on patients with tuberculosis in primary care in Singapore
title_full_unstemmed The impact of direct observed therapy on daily living activities, quality of life and socioeconomic burden on patients with tuberculosis in primary care in Singapore
title_short The impact of direct observed therapy on daily living activities, quality of life and socioeconomic burden on patients with tuberculosis in primary care in Singapore
title_sort impact of direct observed therapy on daily living activities quality of life and socioeconomic burden on patients with tuberculosis in primary care in singapore
url https://doi.org/10.1177/2010105816652148
work_keys_str_mv AT hweekhimlee theimpactofdirectobservedtherapyondailylivingactivitiesqualityoflifeandsocioeconomicburdenonpatientswithtuberculosisinprimarycareinsingapore
AT stephaniesweehongteo theimpactofdirectobservedtherapyondailylivingactivitiesqualityoflifeandsocioeconomicburdenonpatientswithtuberculosisinprimarycareinsingapore
AT sylvainebarbier theimpactofdirectobservedtherapyondailylivingactivitiesqualityoflifeandsocioeconomicburdenonpatientswithtuberculosisinprimarycareinsingapore
AT siewchengtang theimpactofdirectobservedtherapyondailylivingactivitiesqualityoflifeandsocioeconomicburdenonpatientswithtuberculosisinprimarycareinsingapore
AT guathoonyeo theimpactofdirectobservedtherapyondailylivingactivitiesqualityoflifeandsocioeconomicburdenonpatientswithtuberculosisinprimarycareinsingapore
AT ngiapchuantan theimpactofdirectobservedtherapyondailylivingactivitiesqualityoflifeandsocioeconomicburdenonpatientswithtuberculosisinprimarycareinsingapore
AT hweekhimlee impactofdirectobservedtherapyondailylivingactivitiesqualityoflifeandsocioeconomicburdenonpatientswithtuberculosisinprimarycareinsingapore
AT stephaniesweehongteo impactofdirectobservedtherapyondailylivingactivitiesqualityoflifeandsocioeconomicburdenonpatientswithtuberculosisinprimarycareinsingapore
AT sylvainebarbier impactofdirectobservedtherapyondailylivingactivitiesqualityoflifeandsocioeconomicburdenonpatientswithtuberculosisinprimarycareinsingapore
AT siewchengtang impactofdirectobservedtherapyondailylivingactivitiesqualityoflifeandsocioeconomicburdenonpatientswithtuberculosisinprimarycareinsingapore
AT guathoonyeo impactofdirectobservedtherapyondailylivingactivitiesqualityoflifeandsocioeconomicburdenonpatientswithtuberculosisinprimarycareinsingapore
AT ngiapchuantan impactofdirectobservedtherapyondailylivingactivitiesqualityoflifeandsocioeconomicburdenonpatientswithtuberculosisinprimarycareinsingapore