Summary: | 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, h2 = 0.06], time [F (2, 168) = 139.50, p = < 0.001, h2 = 0.62] and group x time interaction [F (2, 168)
= 13.89, p = < 0.001, h2 = 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.
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