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Quality of life, health status and clinical outcomes in Type 2 diabetes patients

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An Erratum to this article was published on 03 March 2007

Abstract

This study examines relationships between patient reported outcomes (PROs) and clinical outcomes in Type 2 diabetes mellitus (T2DM). Patients at the outpatient clinics of a university hospital completed measures of generic health status (SF-12), diabetes-specific quality of life (Audit of Diabetes Dependent Quality of Life – ADDQoL), and depressive symptoms (Center for Epidemiologic Studies Depression – CES-D). Patient reported data were merged with a retrospective collection of clinical and utilization data, including HbA1C, from electronic medical records. A Charlson comorbidity score, diabetes complications score, BMI, and total number of ER and hospital visits were calculated. Usable response rate was 44.3% (n = 385). Patients were dichotomized into glycemic control levels based on the ADA recommended A1C level  < 7.0, vs.  ≥ 7.0. The ADDQoL, PCS-12, and MCS-12 scores were separately examined as dependent variables using hierarchical regression models, with glycemic control as the primary explanatory variable, and controlling for demographics and clinical variables including comorbidities and complications. Glycemic control was not a significant predictor in any regression model. Obesity was a significant predictor leading to poorer PCS-12 and MCS-12 scores, while depressive symptoms significantly resulted in lower PCS-12, MCS-12 and ADDQoL scores. These and other factors related to self-management behaviors may contribute to a greater understanding of how to intervene with patients with T2DM. The use of such PROs alongside biomedical measures such as A1C is recommended.

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Abbreviations

A1C:

HbA1C

ADA:

American Diabetes Association

ADDQoL:

Audit of Diabetes Dependent Quality of Life

ANOVA:

Analysis of Variance

BMI:

Body Mass Index

CES-D:

Center for Epidemiologic Studies-Depression

DCCT:

Diabetes Control and Complications Trial

EMR:

Electronic Medical Records

ER:

Emergency Room

HRQoL:

Health-Related Quality of Life

ICD-9:

International Classification of Diseases 9th revision

MCS-12:

Mental Component Summary-12

PRO:

Patient Reported Outcomes

PCS-12:

Physical Component Summary-12

QoL:

Quality of Life

SF-12:

Medical Outcomes Study Short-Form 12

UKPDS:

United Kingdom Prospective Diabetes Study

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Acknowledgements

The authors would like to acknowledge the coordination support provided by the Office of Medical Staff Affairs and the Department of Family Medicine at the West Virginia University Hospitals, in contacting the patients and in obtaining medical history information. We are also grateful to Clare Bradley (Royal Holloway Department of Psychology), and to QualityMetric Inc. for providing us with academic licenses for the use of the ADDQoL and the SF-12, respectively.

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Authors and Affiliations

  1. Department of Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy, 1122-B, R.C. Byrd Health Sciences Center, 9510, Morgantown, WV, 26506, USA

    Murali Sundaram, Jan Kavookjian, Lesley-Ann Miller, S. Suresh Madhavan & Virginia (Ginger) Scott

  2. Department of Psychology, West Virginia University School of Pharmacy, Morgantown, USA

    Julie Hicks Patrick

Authors
  1. Murali Sundaram
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  2. Jan Kavookjian
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  3. Julie Hicks Patrick
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  5. S. Suresh Madhavan
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  6. Virginia (Ginger) Scott
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Corresponding author

Correspondence to Murali Sundaram.

Additional information

An erratum to this article can be found at http://dx.doi.org/10.1007/s11136-006-9164-2

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Sundaram, M., Kavookjian, J., Patrick, J. et al. Quality of life, health status and clinical outcomes in Type 2 diabetes patients. Qual Life Res 16, 165–177 (2007). https://doi.org/10.1007/s11136-006-9105-0

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