First-Of-Its-Kind Study Demonstrates the Efficacy of Nurse-Led Palliative Care for Multidrug-Resistant TB in Uganda
22 May 2025
In the first randomised controlled trial to report the outcomes for nurse-led palliative care offered alongside continuing tuberculosis treatment, researchers from King’s College London have demonstrated the importance and efficacy of palliative care for multidrug-resistant tuberculosis.
The research was undertaken with colleagues from Hospice Africa Uganda and the African Palliative Care Association.
The report was published in Lancet Global Health.
Study participants were randomly assigned to the intervention (additional nurse-led care) or the standard care control group.
Intervention group participants received nurse-led person-centred holistic assessment, care planning, symptom control and psychosocial support delivered on inpatient wards or at home. Fortnightly appointments alternated between face-to-face visits and telephone follow-ups.
Additional nurse-led palliative care for patients with multidrug-resistant tuberculosis improved self-reported outcomes spanning physical, psychological, social and spiritual domains and increase medication adherence. The report suggests that as a result, person-centred assessment and holistic care with pain and symptom control should be shifted into routine tuberculosis care.
Palliative care is especially important for this group as people with multidrug-resistant tuberculosis experience burdensome symptoms, clinical uncertainty and high mortality.
The World Health Organisation’s (WHO’s) Global Tuberculosis Report 2024 revealed that 8.2m people were diagnosed with tuberculosis during 2023, and 400,000 people developed multidrug-resistant tuberculosis or rifampicin-resistant tuberculosis. The report also identified tuberculosis as the world’s leading cause of death from a single infectious agent in 2022 after COVID-19, with 1.25m deaths caused by this disease.
The Lancet Commission on Pain and Palliative Care identified tuberculosis as a leading cause of serious health-related suffering at the end of life. The World Health Assembly resolution 67.19 calls for palliative care ‘integrated throughout the life course’. The WHO tuberculosis ethics guidance also calls for research to advance palliative and end-of-life care in this realm.
To date, this trial is the first to test palliative care for people with tuberculosis and adds to the evidence base required to meet the goals of palliative care as an essential health service under Universal Health Coverage.
Source: King’s College London
