Health-Related Quality of Life in Poorly Controlled Type 2 Diabetes Patients - Association of Patients’ Characteristics With Eq-5d Domains, Mean Eq-5d Scores, and Visaul Analog Scale Score

Abstract

Objective: High prevalence of diabetes mellitus in Malaysia demands the appropriate interventions to alleviate or postpone its burden on patients' health-related quality of life (HRQoL). The studies which provide useful knowledge about the components of such interventions are important. The aim of this study was to describe how demographic and clinical characteristics of diabetes patients influence their HRQoL using EQ-5D. Methods:This study used the baseline data of a randomized controlled study carried out to examine the impact of a pharmacist intervention on poorly controlled diabetes patients. A generic HRQoL tool EQ-5D was used to report the data. Logistic regression was used to identify the predictors of problems in individual EQ-5D domains, and ANCOVA was undertaken to examine the effect of patients' characteristic on EQ-5D mean scores and visual analog scale (VAS) mean scores.Results: Pain discomfort was reported to be significantly predicted by high HbA1c levels. Increasing age (OR =1.04; CI 1.01, 1.16) and increasing body mass index (OR = 1.15; CI 1.01, 1.30) were significant predictors of reduced mobility. The presence of complications (OR = 8.03; CI 1.34-48.02) and (5-10 years) diabetes duration predicted the reduced score in anxiety domain (OR = 7.05; CI 1.03, 48.04). Problems in usual activities were significantly predicted by age (OR = 1.4; CI 1.01, 1.18). Self-care was not affected by any of the model covariates. Mean EQ-5D score was (0.89; CI 0.85, 0.92) significantly predicted by HbA1c values (p=0.04). Mean VAS score (70.54) was significantly lower in the group receiving insulin (69.46; CI 73.74, 84.02) than the oral diabetes medication (78.88; CI 64.94, 73.98) (p=0.009). Conclusion:Patients' characteristics were significantly associated with the HRQoL in type 2 diabetes. There was a significant and inverse association of HRQoL with medication group (insulin use), high HbA1c, obesity, and presence of complications.

Evaluating the Impact of Therapy on Quality of Life in Type 2 Diabetes: A Literature Review of Utilities Associated with Treatment-Related Attributes

“…Of these, a total of 39 presented findings exclusively related to acute or long-term diabetes-related complications, 15 presented findings exclusively related to the influence of treatment-related attributes on QoL and 15 captured findings on both complications and treatment attributes. Therefore, a total of 30 articles presented utility/disutility values associated with treatment-related attributes or process characteristics ( Table 1 ) 7–36 These included a total of fifteen conducted in Europe, 9–11 , 13–15 , 19–21 , 24 , 25 , 29 , 31 , 33 , 34 eight conducted in Asia, 12 , 17 , 18 , 23 , 27 , 28 , 32 , 35 two in North America, 16 , 36 one in Latin America, 30 one in the Middle East, 8 one in Africa, 7 and two were multinational or the setting was not stated. 22 , 26 Most studies were conducted in people with T2D although three were conducted in general population samples 24 , 28 , 33 and one included both general population groups and groups with T2D.…”

“… 22 , 26 Most studies were conducted in people with T2D although three were conducted in general population samples 24 , 28 , 33 and one included both general population groups and groups with T2D. 29 The most frequently used elicitation method was the EQ-5D (3L or 5L), which was used in fourteen studies, 8 , 12–15 , 18 , 22 , 23 , 25 , 27 , 30 , 32 , 34 , 36 followed by TTO methodology used in ten studies, 10 , 11 , 16 , 19–21 , 24 , 26 , 29 , 33 then the Short Form 6 Dimensions questionnaire (SF-6D; three studies), 15 , 31 , 35 SG (three studies), 9 , 17 , 28 Health Utilities Index-2 (HUI-2; one study), 7 visual analog scale (one study), 17 Health Utilities Index-3 (HUI-3; one study) 7 and the 15D questionnaire (one study). 15 …”

“…A total of twenty studies presented utility or disutility values according to treatment type (diet/exercise alone, oral treatment, insulin or other injectables), 7 , 8 , 10–14 , 18–20 , 22–25 , 27 , 30–32 , 35 , 36 however, only eight were comparative studies in terms of presenting data for patients on different treatment modalities. 8 , 11 , 12 , 14 , 25 , 27 , 30 , 31 In particular, one recent UK-based study specifically assessed QoL according to administration route and also the effect of specific dosing instructions for orally administered treatments. 11 Here, Boye et al showed that patients value simplicity in terms of treatment.…”

Medication Adherence Status and Its Association With Quality of Life Among Individuals With Neurological Conditions in Saudi Arabia

“…On the other hand, studies reported that patients who adhered to their treatment experienced an improvement in QoL and vice versa, as for a study conducted among epileptic patients [ 26 ], and another study among diabetic patients with type 2 diabetes [ 27 ]. This implies that good adherence to medications can provide good control of symptoms, resulting in an improved QoL.…”

Utilities for Complications Associated with Type 2 Diabetes: A Review of the Literature

“…Of these, a total of 39 presented findings exclusively related to acute or long-term diabetes-related complications, 15 presented findings exclusively related to the influence of treatment-related attributes on QoL, and 15 captured findings on both complications and treatment attributes. In total, 54 articles presented utility/disutility values for T2D-related complications (Table 1); these included a total of 18 studies conducted in Asia [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24], 13 conducted in Europe [25][26][27][28][29][30][31][32][33][34][35][36][37], 13 in North America [38][39][40][41][42][43][44][45][46][47][48][49][50], 2 in Latin America [51,52], one in the Middle East …”