Health-Related Quality of Life in Primary Care: Which Aspects Matter in Multimorbid Patients with Type 2 Diabetes Mellitus in a Community Setting?

Abstract

Background and ObjectiveKnowledge about predictors of health-related quality of life for multimorbid patients with type 2 diabetes mellitus in primary care could help to improve quality and patient-centeredness of care in this specific group of patients. Thus, the aim of this study was to investigate the impact of several patient characteristics on health-related quality of life of multimorbid patients with type 2 diabetes mellitus in a community setting.Research Design and MethodsA cross-sectional study with 32 primary care practice teams in Mannheim, Germany, and randomly selected multimorbid patients with type 2 diabetes mellitus (N = 495) was conducted. In order to analyze associations of various patient characteristics with health-related quality of life (EQ-5D index) a multilevel analysis was applied.ResultsAfter excluding patients with missing data, the cohort consisted of 404 eligible patients. The final multilevel model highlighted six out of 14 explanatory patient variables which were significantly associated with health-related quality of life: female gender (r = -0.0494; p = .0261), school education of nine years or less (r = -0.0609; p = .0006), (physical) mobility restrictions (r = -0.1074; p = .0003), presence of chronic pain (r = -0.0916; p = .0004), diabetes-related distress (r = -0.0133; p < .0001), and BMI (r = -0.0047; p = .0045).ConclusionThe findings of this study suggest that increased diabetes-related distress, chronic pain, restrictions in (physical) mobility, female gender, as well as lower education and, increased BMI have a noteworthy impact on health-related quality of life in multimorbid patients with type 2 diabetes mellitus seen in primary care practices in a community setting. The highlighted aspects should gain much more attention when treating multimorbid patients with type 2 diabetes mellitus.

Qualidade de vida em diabéticos assistidos em Estratégia de Saúde da Família na região metropolitana de Porto Alegre, RS, Brasil

“…Contudo, a consulta de enfermagem deve ser efetiva no processo de educação em DM, evitando as complicações da doença que possam interferir na QV. O aumento do sofrimento está relacionado à dor crônica, restrições na mobilidade física, bem como menor escolaridade e aumento do IMC, sendo um impacto notável na qualidade de vida relacionada à saúde em pacientes multimórbidos com DM tipo 2 observado nas práticas de cuidados na atenção primária à saúde 16,17 .…”

Exploring the role of nurses in after-hours telephone services in regional areas; A scoping review

“…Primary and preventative health strategies are highlighted areas to reduce the strain on limited government resources and the financial pressure on individual families, particularly in low income countries [9]. Calculating the financial cost or burden of chronic conditions is complex and the factors included in the analysis are not exhaustive, but often include so-called unnecessary admissions to hospital [10]. It is estimated that around 39% of preventable hospital admissions are from patients with at least one chronic condition.…”

Quality of life of people with diabetes mellitus

“…A cross-sectional study with 495 Germans with Type 2 Diabetes Mellitus (DM2) treated in the primary health unit showed low HRQoL among females, individuals with low education level, physical immobility, chronic pain, emotional distress related to DM and high body mass index, and pointed out that these characteristics of the sample were associated with HRQoL (p <0.05) (8) .…”

“…DM can affect the HRQL due to factors arising from the diagnosis itself (9) , the treatment (11) , the presence of complications and associated morbidities (8) , among others, as well as intrinsic changes in the glucose metabolism of the individuals with the disease over time (9) .…”