Health-related quality of life and its determinants among patients with diabetes mellitus: a multicentre cross-sectional study in Northwest Ethiopia

Abstract

ObjectivesThis study assessed the health-related quality of life (HRQoL) and its determinants in patients with diabetes.Design and settingAn institutional-based multicentre prospective cross-sectional study design was conducted in diabetes follow-up clinics of selected hospitals in Northwest Ethiopia from April to July 2022.ParticipantsAll eligible adult patients with diabetes at the selected facilities.Main outcome measuresHRQoL was measured using EuroQol 5-dimensions 5-levels (EQ-5D-5L) and the EuroQol-Visual Analogue Scales (EQ-VAS) instruments. A lower EQ-5D-5L utility mean score for each dimension and/or an overall lower utility score of EQ-5D-5L and EQ-VAS scores are intended to show poor HRQoL. Linear regression analysis was used to identify the association of HRQoL and other variables.ResultsOut of the 422 samples approached, 402 (95.3%) participated in the study. Most of the participants (>85%) reported having moderate-to-severe problems in all five EQ dimensions. The overall EQ-5D-5L utility and EQ-VAS scores were 0.56 (±0.11) and 56.7 (±10.1), respectively. A higher body mass index (BMI) (p < 0.001), a higher number of medications (p = 0.037), a high level of blood glucose (p < 0.001), the presence of comorbidities and/or complications (p = 0.031), hypoglycaemia (p = 0.043) and taking insulin (p < 0.001) were associated with worsened HRQoL, whereas practicing self-monitoring of blood glucose (p = 0.002) and taking aspirin (p = 0.008) had a significant association with increased HRQoL.ConclusionThis study concluded that the HRQoL of patients was compromised in all five measuring dimensions. The EQ-5D-5L utility and EQ-VAS scores were far lower than other findings. Clinical and medication-related variables, such as a higher BMI, a higher number of medications, the presence of comorbidities and/or complications, hypoglycaemia and insulin use were associated with poor HRQoL in patients with diabetes. As a result, interventions should be individualised and focused on determinant factors.

Investigating the association between medication regimen complexity, medication adherence and treatment satisfaction among Malaysian older adult patients: a cross-sectional study

“…Their finding demonstrated that those with more severe conditions tend to have lower satisfaction due to the high occurrence of symptoms [ 56 ]. Consistent with our finding, a study conducted among diabetic patients in Ethiopia also signifies that complications and multimorbidity were the key determinants of lower degree of treatment satisfaction [ 57 ]. Thus, further studies should focus on assessing this association to identify the actual basis between these variables among older adult patients.…”

Medication regimen complexity and its impact on medication adherence in patients with multimorbidity at a comprehensive specialized hospital in Ethiopia

“…Particularly in Ethiopian settings, most patients are of low socioeconomic status (67,68). On the contrary, most patients with chronic diseases have comorbid conditions and receive multiple medications (36)(37)(38)(39). Thus, patients with a lower income will have a lower level of medication adherence because most multimorbidity patients may be unable to afford treatment costs for multiple medications.…”

“…There is an increasing number of patients with multimorbidity in Ethiopia, and most patients with chronic diseases have at least one comorbid chronic condition with a high number of prescribed medications (36)(37)(38)(39). This could be attributed to the increasing complexity of medication regimens, which in turn impacts patients' medication adherence.…”

Health-related Quality of Life of Patients With Diabetes Mellitus Measured With the Bahasa Indonesia Version of EQ-5D in Primary Care Settings in Indonesia

“…Participants who were not actively engaged in diabetes self-management exhibited lower health outcomes, including quality of life [ 34 ]. A study conducted among type 2 diabetes patients in Ethiopia indicated that a longer duration of DM negatively impacted patients’ quality of life, which may have been related to the discomfort of insulin injections or the pain associated with diabetes complications [ 35 ].…”