EFFECTIVENESS OF COMPREHENSIVE SOCIAL SUPPORT INTERVENTIONS AMONG PATIENTS WITH MULTI-DRUG RESISTANCE TUBERCULOSIS IN NORTHERN TAMIL NADU

Abstract

Introduction: Multi-drug resistant tuberculosis (MDR-TB) poses a significant challenge due to high treatment dropout rates and psychological distress. This study evaluates the impact of comprehensive social support interventions, including Morita therapy, on improving social support, depression status, and treatment adherence among MDR-TB patients in Northern Tamil Nadu.

Methods: A randomized, open-labeled, parallel-group trial was conducted over 24 months (February 2021–February 2023) among 132 newly diagnosed drug-resistant pulmonary TB patients enrolled in the National Tuberculosis Elimination Program (NTEP). Participants were randomly assigned to either the intervention group (receiving Morita therapy, psychoeducation, and health education) or the control group (receiving only health education). Social support levels were assessed using the Social Support Rating Scale (SSRS), while depression severity was measured using the Patient Health Questionnaire-9 (PHQ-9). Data were analyzed using t-tests and repeated measures ANOVA.

Results: The intervention group showed a significant increase in SSRS scores from a baseline mean of 1.109 to 4.012 post-intervention (p<0.001). Significant improvements were noted in all SSRS dimensions—objective support, subjective support, and support utilization. Depression levels (PHQ-9 scores) decreased substantially from 8.377±5.92 to 5.836±4.34 post-intervention (p<0.001), demonstrating a reduction in psychological distress. Additionally, treatment adherence was markedly higher in the intervention group, with 78.8% of patients achieving successful treatment outcomes compared to 70.5% in the control group. Loss to follow-up and mortality rates were lower in the intervention group, indicating a positive impact of psychosocial support on patient retention.

Conclusion: Comprehensive social support interventions significantly enhance treatment adherence, improve social support, and reduce depression among MDR-TB patients. Integrating psychosocial care into TB management is crucial for achieving better treatment outcomes.