Is guideline-adherent prescribing associated with quality of life in patients with type 2 diabetes?

Health state utility values of type 2 diabetes mellitus and related complications: a systematic review and meta-regression

BACKGROUND

This study aimed to synthesize and quantitatively examine Health State Utility Values (HSUVs) for Type 2 Diabetes Mellitus (T2DM) and its complications, providing a robust meta-regression framework for selecting appropriate HSUV estimates.

METHOD

We conducted a systematic review to extract HSUVs for T2DM and its complications, encompassing various influencing factors. Relevant literature was sourced from a review spanning 2000-2020, supplemented by literature from PubMed, Embase, and the Web of Science (up to March 2024). Multivariate meta-regression was performed to evaluate the impact of measurement tools, tariffs, health status, and clinical and demographic variables on HSUVs.

RESULTS

Our search yielded 118 studies, contributing 1044 HSUVs. The HSUVs for T2DM with complications varied, from 0.65 for cerebrovascular disease to 0.77 for neuropathy. The EQ-5D-3L emerged as the most frequently employed valuation method. HSUV differences across instruments were observed; 15-D had the highest (0.89), while HUI-3 had the lowest (0.70) values. Regression analysis elucidated the significant effects of instrument and tariff choice on HSUVs. Complication-related utility decrement, especially in diabetic foot, was quantified. Age <70 was linked to increased HSUVs, while longer illness duration, hypertension, overweight and obesity correlated with reduced HSUVs.

CONCLUSION

Accurate HSUVs are vital for the optimization of T2DM management strategies. This study provided a comprehensive data pool for HSUVs selection, and quantified the influence of various factors on HSUVs, informing analysts and policymakers in understanding the utility variations associated with T2DM and its complications.

Association between medication adherence and health-related quality of life of patients with diabetes

PURPOSE

The purpose was to evaluate the association between medication adherence and health-related quality of life (HRQoL) of patients with diabetes.

METHODS

In this cross-sectional study, a total of 518 patients were recruited from the outpatient departments of different general public and private hospitals in Greece during the COVID-19 pandemic using a consecutive sampling method. HRQoL was assessed with the EQ-5D-5L instrument and medication adherence with the corresponding subscale of the Adherence Starts with Knowledge 20 questionnaire. The relationship between HRQoL and adherence was explored by employing Spearman's correlations and multiple binary logistic and linear stepwise regressions using robust standard errors.

RESULTS

A total of 15.1 and 1.9% of the patients reported that they had taken a medicine either more or less often than prescribed in the last month and week, respectively. Statistically significant but modest correlations of medication non-adherence with the EQ-5D index (rho =  - 0.223), EQ-VAS (rho =  - 0.230), and all the HRQoL domains (rho ranging from 0.211, for pain/discomfort, to 0.136, for mobility issues) were found. These significant associations persisted even after controlling for several other known potential factors of HRQoL in the multivariable analyses, except for the mobility and anxiety/depression dimensions.

CONCLUSION

Medication non-adherence appears to be independently associated with lower HRQoL and health levels in patients with diabetes. It is crucial to plan interventions to enhance medication adherence not only to obtain greater value from the available resources, but also to improve HRQoL of patients with diabetes.

Association between Blood Pressure and Quality of Life of Patients with Diabetes Mellitus Type 2 in the Bogor City Indonesia

BACKGROUND: Quality of life (QoL) related to health is an important aspect in the treatment of diabetes mellitus (DM). AIM: This study aims to find a relationship between blood pressure and QoL of patients with DM Type 2 by controlling other variables. METHODS: This is a cross-sectional study of DM patients in Bogor City who were community-based participants with inclusion and exclusion criteria. The QoL data were collected using DM QoL modification questionnaire. Statistical analyses were performed using logistic regression. RESULTS: The result of the study conducted on 144 people with DM, more than half of the patients had hypertension (68.1%), adults aged 25–60 years (69.4%), women (79.9%), low education with <12 years of education year (62.5%), not working formally (66.0%), married (77.8%), and getting treatment (75.7%). The QoL of patients is balanced between good and poor QoL (50%). Based on the results of the bivariate test, blood pressure, education, and marital status had a significant relationship to QoL (p < 0.05). Based on multivariate test results, the OR value for blood pressure does not increase or decrease by more than 10% in the full model or partially, this indicates that the effect of pressure on QoL is relatively stable (OR = 0.293). CONCLUSION: DM patients who are not hypertensive can be a protective factor against poor QoL. The multivariate final model shows that the variable that greatly influences the QoL is education (OR = 3.63). Blood pressure, education, and married have a significant relationship to the QoL of patients with DM (p < 0.05). Age, sex, occupation, and therapy were not statistically related (p > 0.05).