Impact of patient care interventions on clinical, humanistic, and treatment outcomes of tuberculosis patients with diabetes mellitus: A systematic review

Background: Tuberculosis (TB) and diabetes mellitus (DM) are major global health concerns that frequently coexist, particularly in low- and middle-income countries. This dual burden negatively affects disease progression and outcomes. The patient care interventions have demonstrated benefits in chronic disease management. However, interventions designed specifically for individuals with TB-DM co-morbidity remain poorly understood. Objective: To systematically review the impact of patient care interventions on clinical, humanistic, and treatment outcomes among TB-DM patients. Methods: A comprehensive literature search was conducted in PubMed, Embase, and Scopus from inception to April 2025. Interventional studies evaluating the effects of patient care interventions in adults with TB-DM comorbidity were included. Outcomes were categorized as clinical (e.g., glycemic control), humanistic (e.g., patient knowledge, adherence), and treatment-related (e.g., TB treatment success). The risk of bias was assessed using the Cochrane risk of bias tool. A narrative synthesis was performed due to heterogeneity in interventions and outcomes. Results: Three randomized controlled trials (RCTs) conducted in Malaysia and Indonesia between 2021 and 2023 met the inclusion criteria. Interventions included structured patient educational counselling, glucose monitoring, and medication adherence support. Two studies observed improved glycemic control, while all reported enhanced patient knowledge and adherence. Only one study reported TB treatment outcomes, showing improved cure and success rates following the intervention. The overall risk of bias was low to moderate. Conclusion: The evidence suggests that patient care interventions may improve clinical and humanistic outcomes, as well as potentially treatment outcomes, in patients with TB-DM comorbidity. These findings support the integration of structured patient support strategies into multidisciplinary care models for TB-DM comorbidity. Further large-scale, multicenter trials are needed to validate these findings and assess long-term impact.