Psychosocial challenges of drug-resistant tuberculosis: A qualitative study in Deoghar, Eastern India

Background and objectives Despite therapeutic advancements, patients with drug-resistant TB (DR-TB) experience substantial psychosocial challenges that adversely affect treatment adherence and outcomes. Limited research has explored these psychosocial barriers. This study aimed to explore the psychosocial challenges encountered by DR-TB patients from diagnosis through treatment completion. Methods A cross-sectional qualitative study was conducted in the department of Pulmonary Medicine at a tertiary care hospital in eastern India from November to December 2023. Using criterion sampling, 20 DR-TB patients who had successfully completed treatment were recruited. Semi-structured, face-to-face interviews were conducted in Hindi, audio-recorded, transcribed verbatim, and thematically analysed using QDA Miner Lite software following Braun and Clarke's six-step framework. Results Six major themes emerged: (i) Diagnosis-related challenges such as delays, lack of awareness, and misguidance; (ii) Physical and mental health impact, including severe drug-related side effects leading to distress and suicidal thoughts; (iii) Emotional instability, marked by fear, anxiety, and hopelessness; (iv) Family isolation and disruption of social relationships due to stigma and misconceptions; (v) Lack of social support, resulting in discrimination and reduced self-esteem; and (vi) Financial burden, including job loss, treatment-related costs, and debt. Interpretation and conclusions Psychosocial barriers substantially influence treatment adherence and overall well-being among DR-TB patients. Integrating mental health services, strengthening counselling, addressing stigma, and providing financial assistance within the National TB Elimination Program (NTEP) are essential to improve patient support, adherence, and clinical outcomes.