Alleviating psychosocial distress in drug-resistant tuberculosis: a pre-post study on telephone-delivered...

This pilot feasibility study aimed to evaluate the efficacy of a telephone-delivered motivational interviewing (MI) intervention in alleviating loneliness, depressive symptoms, and anxiety among patients with drug-resistant tuberculosis (DR-TB).

Employing a single-group pre-post design, 74 DR-TB patients were recruited from the tuberculosis wards of Chengdu Public Health Clinical Medical Center between January and December 2021. Participants underwent a 12-week MI-based telephone intervention, with assessments at baseline (Week 0) and post-intervention (Week 16). Primary outcomes included changes in psychological measures using validated instruments: the University of California, Los Angeles Loneliness Scale (UCLA-LS), Self-Rating Depression Scale (SDS), and Hamilton Anxiety Rating Scale (HAMA). Secondary outcomes encompassed sleep quality, assessed by the Pittsburgh Sleep Quality Index (PSQI), and medication adherence, defined as a binary outcome based on pill count.

The intervention significantly reduced loneliness (UCLA-LS: 47.23 ± 10.14 → 40.23 ± 12.76, p < 0.001; 14.8% decrease), anxiety (HAMA: 14.73 ± 8.85 → 12.06 ± 7.34, p = 0.017; 18.1% reduction), and depressive symptoms (SDS: 50.47 ± 9.33 → 34.85 ± 9.06, p < 0.001; 30.9% decline). Sleep quality improved (PSQI: 7.75 ± 0.68 → 4.20 ± 1.44, p < 0.001; 45.8% decline), while medication adherence increased from 89.2 to 95.4%, this change was not statistically significant (p > 0.05, McNemar's test).

This pilot pre-post study provides preliminary evidence that telephone-delivered MI is associated with improved psychological outcomes in DR-TB patients. The findings support its promise as an accessible intervention, but the exploratory design necessitates further investigation through controlled trials to confirm efficacy and establish causal inference.