Health-related quality of life and treatment adherence in tuberculosis–diabetes comorbidity in urban India

Background: Tuberculosis (TB) and diabetes mellitus (DM) form a growing syndemic that adversely affects treatment outcomes and patient well-being. While clinical consequences are well documented, patient-centred outcomes such as health-related quality of life (HRQoL) and treatment adherence remain inadequately explored in high-burden settings. This study aimed to assess HRQoL and treatment adherence among patients with TB–DM comorbidity receiving anti-tubercular therapy in an urban tertiary care hospital. Methods: A hospital-based cross-sectional study was conducted among adult patients with TB–DM comorbidity receiving anti-tubercular therapy. HRQoL was assessed using the WHOQOL-BREF across physical, psychological, social, and environmental domains. Treatment adherence was measured using the Tuberculosis Medication Adherence Scale (TBMAS). Data were analysed using appropriate statistical tests, with p<0.05 considered statistically significant. Results: The majority of participants were aged 26-40 years, male, and urban residents. Poor HRQoL was most pronounced in the psychological and environmental domains, while nearly one-third had poor physical HRQoL. Social HRQoL was impaired in a substantial proportion of participants. High-risk behaviours were common, including tobacco use and alcohol consumption. Despite high treatment adherence observed in 166 (89.2%) participants, HRQoL remained poor, particularly in the psychological [132 (71.0%)] and environmental domains [141 (75.8%)]. Conclusions: Although most participants demonstrated good treatment adherence, substantial impairment in HRQoL persisted, particularly in psychological and environmental domains.