A co-morbid patient of a phthisiologist, pulmonologist and cardiologist: focus on quality of life

Abstract

The objective: to assess the impact of tuberculosis (TB), chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) on the quality of life (QOL) and the need to manage each disease to improve the physical and mental components of QOL.Subjects and Methods. A simple prospective study included 80 patients, men – 53.9%, women – 46.1% who were divided into 3 groups: Group 1 – COPD (n = 35), median age [Me (25.0; 75.0 )] 56.0 (54.0; 60.0) years old, Group 2 – COPD + TB (n = 25), 58.0 (56.0; 59.0) years old, Group 3 – COPD + TB + CHF with preserved ejection fraction (n = 20), 60.0 (57.0; 64.0) years old. QOL was assessed using the SF-36 questionnaire. There were no statistically signifcant differences between the compared groups in terms of COPD severity and TB forms.Results. Low QOL indices were observed in TB + COPD + CHF Group assessed by all scores especially for physical (30 points) and social functioning (35 points) and general health (35 points). After 3 months of therapy aimed to manage all pathological conditions, a positive trend in QOL was achieved in TB + COPD + CHF Group in terms of physical and mental health scores.Conclusion. QOL in co-morbid patients is determined not only by the quality and severity of individual nosologies but also by their number. Comprehensive therapy improves the general subjective state of the patient that helps to improve adherence to drug therapy thereby increasing the chance of recovery.