Outcomes Research/Real World Data Team, Corporate Affairs and Health & Value Division, Pfizer Pharmaceuticals Korea Ltd., Seoul, Korea.
Department of Endocrinology and Metabolism, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.
Diabetes Metab J. 2020 Feb;44(1):91-102. doi: 10.4093/dmj.2018.0251. Epub 2019 Oct 23.
Diabetes mellitus (DM) is the most common chronic metabolic disorder with an increasing prevalence worldwide. According to a previous study, physicians' treatment patterns or patients' behaviors change when they become aware of the risk for cardiovascular (CV) disease in patients with DM. However, there exist controversial reports from previous studies in the impact of physicians' behaviors on the patients' quality of life (QoL) improvements. So we investigate the changes in QoL according to physicians and patients' behavioral changes after the awareness of CV risks in patients with type 2 DM.
Data were obtained from a prospective, observational study where 799 patients aged ≥40 years with type 2 DM were recruited at 24 tertiary hospitals in Korea. Changes in physicians' behaviors were defined as changes in the dose/type of antihypertensive, lipid-lowering, and anti-platelet therapies within 6-month after the awareness of CV risks in patients. Changes in patients' behaviors were based on lifestyle modifications. Audit of Diabetes Dependent Quality of Life comprising 19-life-domains was used.
The weighted impact score change for local or long-distance journey (=0.0049), holidays (=0.0364), and physical health (=0.0451) domains significantly differed between the two groups; patients whose physician's behaviors changed showed greater improvement than those whose physician's behaviors did not change.
This study demonstrates that changes in physicians' behaviors, as a result of perceiving CV risks, improve QoL in some domains of life in DM patients. Physicians should recognize the importance of understanding CV risks and implement appropriate management.
糖尿病(DM)是最常见的慢性代谢紊乱,全球患病率呈上升趋势。根据之前的一项研究,当医生意识到糖尿病患者存在心血管(CV)疾病风险时,他们的治疗模式或患者的行为会发生变化。然而,之前的研究对于医生的行为对患者生活质量(QoL)改善的影响存在争议报告。因此,我们调查了 2 型糖尿病患者 CV 风险意识后,根据医生和患者的行为变化,QoL 的变化情况。
数据来自一项前瞻性、观察性研究,在韩国的 24 家三级医院共招募了 799 名年龄≥40 岁的 2 型糖尿病患者。医生行为的变化定义为在患者 CV 风险意识增强后 6 个月内,调整降压、降脂和抗血小板治疗的剂量/类型。患者行为的变化是基于生活方式的改变。使用包含 19 个生活领域的糖尿病依赖性生活质量评估量表进行评估。
在本地或长途旅行(=0.0049)、假期(=0.0364)和身体健康(=0.0451)领域,两组之间的加权影响评分变化有显著差异;医生行为发生变化的患者比医生行为没有变化的患者在这些领域的生活质量改善更显著。
这项研究表明,医生感知 CV 风险后,改变行为可以改善糖尿病患者某些生活领域的 QoL。医生应该认识到了解 CV 风险的重要性,并实施适当的管理。