Future orientation moderates the relationship between medication adherence and health-related quality of life among people with drug-resistant tuberculosis in Lagos, Nigeria: a cross-sectional study
- 1Department of Basic Medical Sciences, Durban University of Technology, Durban, South Africa
- 2Mainland Hospital, Yaba, Lagos, Nigeria
- 3Faculty of Health Sciences, Durban University of Technology, Durban, South Africa
Abstract
Background: Future orientation is the tendency to prioritise long-term outcomes over immediate consequences, which may influence how individuals engage with prolonged and demanding treatment regimens. Its role in shaping patient-centred outcomes among people with drug-resistant tuberculosis (PwDR-TB) remains poorly understood. This study examined whether future orientation moderates the association between medication adherence and health-related quality of life (HRQoL) among PwDR-TB in Lagos, Nigeria.
Methods: A cross-sectional study was conducted among 203 PwDR-TB receiving care at five treatment centres in Lagos. HRQoL was assessed with the Functional Assessment of Chronic Illness Therapy–Tuberculosis (FACIT-TB), medication adherence with the 8-item Morisky Medication Adherence Scale (MMAS-8), and future orientation with the Deferment of Gratification Scale. Hierarchical multiple regression was used to examine the moderating effect of future orientation on the association between adherence and HRQoL, adjusting for relevant sociodemographic and clinical covariates. Simple slopes analysis was conducted to interpret significant interactions.
Results: Participants classified as adherent had significantly higher HRQoL scores across all domains (p < 0.001). Medication adherence was positively associated with HRQoL (β = 0.316, p < 0.001), as was future orientation (β = 0.262, p < 0.001). The interaction between adherence and future orientation was statistically significant (β = 0.201, p = 0.018), indicating moderation. However, the interaction explained a small proportion of additional variance in HRQoL (ΔR² = 0.016), suggesting a modest effect size. The positive association between adherence and HRQoL was stronger at higher levels of future orientation.
Conclusion: Future orientation was associated with differences in the relationship between adherence and HRQoL, although the interaction was modest. Longitudinal studies are required to determine whether future orientation prospectively modifies this relationship before implications for intervention can be established.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12879-026-14163-z.
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BibTeX
@article{adejumo2026future,
title = {{Future orientation moderates the relationship between medication adherence and health-related quality of life among people with drug-resistant tuberculosis in Lagos, Nigeria: a cross-sectional study}},
author = {Olusola Adedeji Adejumo and Champaklal Jinabhai and Firoza Haffejee},
journal = {BMC Infectious Diseases},
year = {2026},
month = aug,
doi = {10.1186/s12879-026-14163-z},
url = {https://doi.org/10.1186/s12879-026-14163-z},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Future orientation moderates the relationship between medication adherence and health-related quality of life among people with drug-resistant tuberculosis in Lagos, Nigeria: a cross-sectional study
AU - Olusola Adedeji Adejumo
AU - Champaklal Jinabhai
AU - Firoza Haffejee
PY - 2026
DA - 2026/08/06
JO - BMC Infectious Diseases
DO - 10.1186/s12879-026-14163-z
UR - https://doi.org/10.1186/s12879-026-14163-z
AB - Background: Future orientation is the tendency to prioritise long-term outcomes over immediate consequences, which may influence how individuals engage with prolonged and demanding treatment regimens. Its role in shaping patient-centred outcomes among people with drug-resistant tuberculosis (PwDR-TB) remains poorly understood. This study examined whether future orientation moderates the association between medication adherence and health-related quality of life (HRQoL) among PwDR-TB in Lagos, Nigeria. Methods: A cross-sectional study was conducted among 203 PwDR-TB receiving care at five treatment centres in Lagos. HRQoL was assessed with the Functional Assessment of Chronic Illness Therapy–Tuberculosis (FACIT-TB), medication adherence with the 8-item Morisky Medication Adherence Scale (MMAS-8), and future orientation with the Deferment of Gratification Scale. Hierarchical multiple regression was used to examine the moderating effect of future orientation on the association between adherence and HRQoL, adjusting for relevant sociodemographic and clinical covariates. Simple slopes analysis was conducted to interpret significant interactions. Results: Participants classified as adherent had significantly higher HRQoL scores across all domains (p < 0.001). Medication adherence was positively associated with HRQoL (β = 0.316, p < 0.001), as was future orientation (β = 0.262, p < 0.001). The interaction between adherence and future orientation was statistically significant (β = 0.201, p = 0.018), indicating moderation. However, the interaction explained a small proportion of additional variance in HRQoL (ΔR² = 0.016), suggesting a modest effect size. The positive association between adherence and HRQoL was stronger at higher levels of future orientation. Conclusion: Future orientation was associated with differences in the relationship between adherence and HRQoL, although the interaction was modest. Longitudinal studies are required to determine whether future orientation prospectively modifies this relationship before implications for intervention can be established. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12879-026-14163-z.
SN - 1471-2334
ER -