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Braga de Souza ACC, Felício JS, Koury CC, Neto JFA, Miléo KB, Santos FM, Negrato CA, Motta ARB, Silva DD, Arbage TP, Carvalho CT, de Rider Brito HA, Yamada ES, Cunha de Melo FT, Resende FDS, Ferreira JCC, Gomes MB. Health-related quality of life in people with type 1 Diabetes Mellitus: data from the Brazilian Type 1 Diabetes Study Group. Health Qual Life Outcomes 2015; 13:204. [PMID: 26703221 PMCID: PMC4690259 DOI: 10.1186/s12955-015-0396-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 12/11/2015] [Indexed: 11/10/2022] Open
Abstract
Background Type 1 Diabetes Mellitus (Type 1 DM) affects the psychological and emotional well-being of patients and their families. This study aims to evaluate the health- related quality of life (HRQoL) of people with Type 1 DM in Brazil, a country of continental proportions, using the EuroQol questionnaires. Methods This was a retrospective, cross-sectional, multicenter study performed by the Brazilian Type 1 Diabetes Study Group, by analyzing EuroQol scores from 3,005 participants with Type 1 DM, in 28 public clinics in Brazil. Data on demography, economical status, chronic complications, glycemic control and lipid profile were also collected. Results The assessment of HRQoL by the EuroQol showed that the average score assigned to general health in Brazil is markedly lower than those found in two other Type 1 DM population-based studies conducted in Europe (EQ–VAS from the Netherlands, the United Kingdom and Brazil were 80.8 ± 15.2, 75.1 ± 18.4 and 72.5 ± 22, respectively). Additionally, our data suggest that a better glycemic control could positively impact the HRQoL of people with Type 1 DM, implying that each 1 % reduction in glycated haemoglobin might lead to an increase of 1.5 points in general health status assessed by the EuroQol. Conclusions This is a population-based study evaluating the HRQoL of people with Type 1 DM in Brazil. Our data indicate a worse quality of health of people with Type 1 DM in Brazil in comparison to Europe, and suggest that a better glycemic control could positively impact the HRQoL of these individuals. However, this study points to the existence of additional factors not yet evaluated that could be determinant in the HRQoL of these people.
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Affiliation(s)
- Ana Carolina Contente Braga de Souza
- University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, 66073-000, Belém, Pará, Brazil.
| | - João Soares Felício
- University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, 66073-000, Belém, Pará, Brazil.
| | - Camila Cavalcante Koury
- University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, 66073-000, Belém, Pará, Brazil.
| | - João Felício Abrahão Neto
- University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, 66073-000, Belém, Pará, Brazil.
| | - Karem Barbosa Miléo
- University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, 66073-000, Belém, Pará, Brazil.
| | - Flávia Marques Santos
- University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, 66073-000, Belém, Pará, Brazil.
| | - Carlos Antonio Negrato
- Bauru's Diabetics Association, Internal Medicine, Nações Unidas Avenue, 28040, Centro, 17010-130, Bauru, São Paulo, Brazil.
| | - Ana Regina Bastos Motta
- University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, 66073-000, Belém, Pará, Brazil.
| | - Denisson Dias Silva
- University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, 66073-000, Belém, Pará, Brazil.
| | - Thaís Pontes Arbage
- University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, 66073-000, Belém, Pará, Brazil.
| | - Carolina Tavares Carvalho
- University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, 66073-000, Belém, Pará, Brazil.
| | - Hana Andrade de Rider Brito
- University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, 66073-000, Belém, Pará, Brazil.
| | - Elizabeth Sumi Yamada
- University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, 66073-000, Belém, Pará, Brazil.
| | - Franciane Trindade Cunha de Melo
- University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, 66073-000, Belém, Pará, Brazil.
| | - Fabricio de Souza Resende
- University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, 66073-000, Belém, Pará, Brazil.
| | - Juliana Cristina Cardoso Ferreira
- University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, 66073-000, Belém, Pará, Brazil.
| | - Marilia Brito Gomes
- State University of Rio de Janeiro, Diabetes Unit, Boulevard 28 de setembro, 77, Vila Isabel, 20551-030, Rio de Janeiro, Rio de Janeiro, Brazil.
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Veilleux N, Goffaux P, Boudrias M, Mathieu D, Daigle K, Fortin D. Quality of life in neurooncology—age matters. J Neurosurg 2010; 113:325-32. [DOI: 10.3171/2010.2.jns091707] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Object
Due partly to therapeutic improvements and prolonged patient survival, the field of neurooncology is gradually undergoing a philosophical shift, progressively moving toward a more functional approach to patient welfare. This shift includes, as one of its defining objectives, the promotion of elevated levels of quality of life (QOL) and quality of health (QOH) for patients of all ages. Unfortunately, an adult life-stage perspective has never been used to study the long-lasting impact of age on well-being in neurooncology patients.
Methods
In this study, the authors assessed and compared the QOL and QOH scores of 42 younger adults (≤ 40 years of age) and 88 older adults (> 40 years of age) presenting with a primary supratentorial tumor.
Results
After having controlled for biomedical and treatment-related factors, the authors discovered that older adults reported lower functional well-being and poorer neurocognitive functioning than younger adults. This age difference appeared earlier than expected (developing as early as middle age), suggesting an accelerated effect of disease on the aging process. Importantly, it was also found that the variables that predict QOL and QOH differed depending on patient age. For example, support from friends was a significant predictor of QOL for younger adults, whereas the capacity to continue enjoying life was a significant predictor for older adults. Moreover, the presence of a high-grade tumor and increased physical pain had a negative impact on the QOH of younger adults, whereas increased difficulty with concentration negatively impacted the QOH of older adults.
Conclusions
These age differences clearly warn against consolidating the QOL or QOH scores of younger and older adults, and instead suggest that age at diagnosis is essential when considering patient perspective, and when establishing tailored support programs.
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Sundaram M, Kavookjian J, Patrick JH, Miller LA, Madhavan SS, Scott VG. Quality of life, health status and clinical outcomes in Type 2 diabetes patients. Qual Life Res 2006; 16:165-77. [PMID: 17033903 DOI: 10.1007/s11136-006-9105-0] [Citation(s) in RCA: 102] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2005] [Accepted: 07/29/2006] [Indexed: 12/12/2022]
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. >or= 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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Affiliation(s)
- Murali Sundaram
- 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.
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