In the first nationwide survey investigating post-TB care in NHS services, clinicians reported encountering a broad range of (physical and non-physical) problems among their patients, with ongoing care mixed and informal.
The research, carried out by researchers at the University of Leicester with funding from the NIHR Leicester Biomedical Research Centre (BRC), and Imperial College London have been published in BMJ Open Respiratory Research.
Clinical Research Fellow at the University of Leicester, Ailva O’Reilly, said: “Tuberculosis survivors often experience long-term illness, which contributes substantially to the global burden of TB.
“In the UK, where TB incidence is rising, the scale of post-TB health needs isn’t clear. We conducted the first nationwide survey of UK TB services to assess their approaches to post-TB care.”
A digital survey was sent out to NHS TB services in England, Scotland, Wales and Northern Ireland which asked for data on types of post-TB problems their patients experience and their current clinical practice.
“We received responses from 113 of 135 TB services and nearly all, 96% of them, had encountered at least one type of post-TB problem in their patient populations, including post-TB lung disease (82%).”
Clinicians also frequently reported social vulnerabilities and financial issues among their patients.
While end of treatment symptom screening and chest X-rays are routine (more than 95% of these services did this), fewer than half of services perform assessments for broader post-TB health issues and provide direct ongoing medical care (41%).
Most services cited staffing (78%), clinic capacity (70%) and funding (59%) as challenges to post-TB care.
Professor Manish Pareek, Chair in Infectious Diseases and Infection lead in the NIHR Leicester BRC said: “Tuberculosis continues to disproportionately affect underserved communities and this work highlights the need to better understand how TB survivors and TB physicians can be supported after completion of TB treatment.”
Dr Jamilah Meghji, Clinical Associate Professor at Imperial College London added: “The majority of UK TB clinicians recognise that their patients face ongoing symptoms, psychosocial, and economic challenges even after TB treatment completion.
“Better data on post-TB morbidity in the UK, and clear guidance for clinicians would help us to support the long-term wellbeing of our patients.”
For the full paper, please visit: https://bmjopenrespres.bmj.com/content/13/1/e004021