Impact of comorbidity on health-related quality of life among type 2 diabetic patients in primary care

Sandipana Pati; Sanghamitra Pati; Marjan van den Akker; F. (Francois) G. Schellevis; Sunita Jena; Jako S. Burgers

doi:10.1017/S1463423620000055

Impact of comorbidity on health-related quality of life among type 2 diabetic patients in primary care

Sandipana Pati^*, Sanghamitra Pati, Marjan van den Akker, F. (Francois) G. Schellevis, Sunita Jena, Jako S. Burgers

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Health-related quality of life (HRQL) is an important outcome for chronic diseases such as diabetes mellitus that is associated with complications, comorbidities, and lifelong care.Objectives: The present study aims to explore the impact of comorbidities on the different dimensions of HRQL among type 2 diabetic patients attending primary care.Methods: A total of 912 type 2 diabetic patients attending primary care centers in India were assessed using a predesigned and pretested questionnaire - Diabetes Comorbidity Evaluation Tool in Primary Care. The HRQL was measured by physical and mental health summary scores [physical component summary (PCS) and mental component summary (MCS)] of the Short Form Health Survey 12. The associations of sociodemographic variables and clinical variables with PCS and MCS were assessed, and a minimal difference of 5 in the scores (on a scale of 0-100) was kept as clinically relevant difference for this study. Mean differences in mental (MCS) and physical (PCS) scores of quality of life by number and type of comorbid conditions in type 2 diabetic patients were calculated.Result: The presence of comorbid conditions was associated with lower scores of PCS and MCS (P < 0.001). Significant reduction in HRQL was found with increase in number of comorbid conditions, and negative association was established between the number of comorbidities and the PCS (r = -0.25, P < 0.0001) and MCS scores (r = -0.21, P < 0.0001). Among comorbidities, acid peptic disease, chronic lung disease, visual impairment, depression, and stroke had significantly and clinically relevant reduced scores. Duration of diabetes, use of insulin, and obesity were also associated with poor HRQL.Conclusion: Comorbidities considerably impair the HRQL among type 2 diabetic patients. National programs designed for diabetes management should also take into account the challenges of coexisting chronic conditions and its substantial effect on HRQL.

Original language	English
Article number	9
Pages (from-to)	1-8
Number of pages	8
Journal	Primary health care research & development
Volume	21
DOIs	https://doi.org/10.1017/S1463423620000055
Publication status	Published - 2020

Keywords

comorbidity
health-related quality of life
primary care
SF-12
type 2 diabetes
POPULATION
DISEASE
MULTIMORBIDITY
MELLITUS

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10.1017/S1463423620000055Licence: CC BY-NC-ND

Cite this

@article{3db51e7deb8d4ce19cfa3f121d46489d,

title = "Impact of comorbidity on health-related quality of life among type 2 diabetic patients in primary care",

abstract = "Health-related quality of life (HRQL) is an important outcome for chronic diseases such as diabetes mellitus that is associated with complications, comorbidities, and lifelong care.Objectives: The present study aims to explore the impact of comorbidities on the different dimensions of HRQL among type 2 diabetic patients attending primary care.Methods: A total of 912 type 2 diabetic patients attending primary care centers in India were assessed using a predesigned and pretested questionnaire - Diabetes Comorbidity Evaluation Tool in Primary Care. The HRQL was measured by physical and mental health summary scores [physical component summary (PCS) and mental component summary (MCS)] of the Short Form Health Survey 12. The associations of sociodemographic variables and clinical variables with PCS and MCS were assessed, and a minimal difference of 5 in the scores (on a scale of 0-100) was kept as clinically relevant difference for this study. Mean differences in mental (MCS) and physical (PCS) scores of quality of life by number and type of comorbid conditions in type 2 diabetic patients were calculated.Result: The presence of comorbid conditions was associated with lower scores of PCS and MCS (P < 0.001). Significant reduction in HRQL was found with increase in number of comorbid conditions, and negative association was established between the number of comorbidities and the PCS (r = -0.25, P < 0.0001) and MCS scores (r = -0.21, P < 0.0001). Among comorbidities, acid peptic disease, chronic lung disease, visual impairment, depression, and stroke had significantly and clinically relevant reduced scores. Duration of diabetes, use of insulin, and obesity were also associated with poor HRQL.Conclusion: Comorbidities considerably impair the HRQL among type 2 diabetic patients. National programs designed for diabetes management should also take into account the challenges of coexisting chronic conditions and its substantial effect on HRQL.",

keywords = "comorbidity, health-related quality of life, primary care, SF-12, type 2 diabetes, POPULATION, DISEASE, MULTIMORBIDITY, MELLITUS",

author = "Sandipana Pati and Sanghamitra Pati and {van den Akker}, Marjan and Schellevis, {F. (Francois) G.} and Sunita Jena and Burgers, {Jako S.}",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2020.",

year = "2020",

doi = "10.1017/S1463423620000055",

language = "English",

volume = "21",

pages = "1--8",

journal = "Primary health care research & development",

issn = "1463-4236",

publisher = "Cambridge University Press",

}

TY - JOUR

T1 - Impact of comorbidity on health-related quality of life among type 2 diabetic patients in primary care

AU - Pati, Sandipana

AU - Pati, Sanghamitra

AU - van den Akker, Marjan

AU - Schellevis, F. (Francois) G.

AU - Jena, Sunita

AU - Burgers, Jako S.

N1 - Publisher Copyright: © The Author(s) 2020.

PY - 2020

Y1 - 2020

N2 - Health-related quality of life (HRQL) is an important outcome for chronic diseases such as diabetes mellitus that is associated with complications, comorbidities, and lifelong care.Objectives: The present study aims to explore the impact of comorbidities on the different dimensions of HRQL among type 2 diabetic patients attending primary care.Methods: A total of 912 type 2 diabetic patients attending primary care centers in India were assessed using a predesigned and pretested questionnaire - Diabetes Comorbidity Evaluation Tool in Primary Care. The HRQL was measured by physical and mental health summary scores [physical component summary (PCS) and mental component summary (MCS)] of the Short Form Health Survey 12. The associations of sociodemographic variables and clinical variables with PCS and MCS were assessed, and a minimal difference of 5 in the scores (on a scale of 0-100) was kept as clinically relevant difference for this study. Mean differences in mental (MCS) and physical (PCS) scores of quality of life by number and type of comorbid conditions in type 2 diabetic patients were calculated.Result: The presence of comorbid conditions was associated with lower scores of PCS and MCS (P < 0.001). Significant reduction in HRQL was found with increase in number of comorbid conditions, and negative association was established between the number of comorbidities and the PCS (r = -0.25, P < 0.0001) and MCS scores (r = -0.21, P < 0.0001). Among comorbidities, acid peptic disease, chronic lung disease, visual impairment, depression, and stroke had significantly and clinically relevant reduced scores. Duration of diabetes, use of insulin, and obesity were also associated with poor HRQL.Conclusion: Comorbidities considerably impair the HRQL among type 2 diabetic patients. National programs designed for diabetes management should also take into account the challenges of coexisting chronic conditions and its substantial effect on HRQL.

AB - Health-related quality of life (HRQL) is an important outcome for chronic diseases such as diabetes mellitus that is associated with complications, comorbidities, and lifelong care.Objectives: The present study aims to explore the impact of comorbidities on the different dimensions of HRQL among type 2 diabetic patients attending primary care.Methods: A total of 912 type 2 diabetic patients attending primary care centers in India were assessed using a predesigned and pretested questionnaire - Diabetes Comorbidity Evaluation Tool in Primary Care. The HRQL was measured by physical and mental health summary scores [physical component summary (PCS) and mental component summary (MCS)] of the Short Form Health Survey 12. The associations of sociodemographic variables and clinical variables with PCS and MCS were assessed, and a minimal difference of 5 in the scores (on a scale of 0-100) was kept as clinically relevant difference for this study. Mean differences in mental (MCS) and physical (PCS) scores of quality of life by number and type of comorbid conditions in type 2 diabetic patients were calculated.Result: The presence of comorbid conditions was associated with lower scores of PCS and MCS (P < 0.001). Significant reduction in HRQL was found with increase in number of comorbid conditions, and negative association was established between the number of comorbidities and the PCS (r = -0.25, P < 0.0001) and MCS scores (r = -0.21, P < 0.0001). Among comorbidities, acid peptic disease, chronic lung disease, visual impairment, depression, and stroke had significantly and clinically relevant reduced scores. Duration of diabetes, use of insulin, and obesity were also associated with poor HRQL.Conclusion: Comorbidities considerably impair the HRQL among type 2 diabetic patients. National programs designed for diabetes management should also take into account the challenges of coexisting chronic conditions and its substantial effect on HRQL.

KW - comorbidity

KW - health-related quality of life

KW - primary care

KW - SF-12

KW - type 2 diabetes

KW - POPULATION

KW - DISEASE

KW - MULTIMORBIDITY

KW - MELLITUS

U2 - 10.1017/S1463423620000055

DO - 10.1017/S1463423620000055

M3 - Article

C2 - 32248877

SN - 1463-4236

VL - 21

SP - 1

EP - 8

JO - Primary health care research & development

JF - Primary health care research & development

M1 - 9

ER -