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健康相关生活质量及其决定因素在糖尿病患者中的研究:埃塞俄比亚西北部的一项多中心横断面研究。

Health-related quality of life and its determinants among patients with diabetes mellitus: a multicentre cross-sectional study in Northwest Ethiopia.

机构信息

Department of Clinical Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia

Department of Pharmacy, College of Health Science, Debre Markos University, Debre Markos, Ethiopia.

出版信息

BMJ Open. 2023 Jan 25;13(1):e068518. doi: 10.1136/bmjopen-2022-068518.

Abstract

OBJECTIVES

This study assessed the health-related quality of life (HRQoL) and its determinants in patients with diabetes.

DESIGN AND SETTING

An institutional-based multicentre prospective cross-sectional study design was conducted in diabetes follow-up clinics of selected hospitals in Northwest Ethiopia from April to July 2022.

PARTICIPANTS

All eligible adult patients with diabetes at the selected facilities.

MAIN OUTCOME MEASURES

HRQoL was measured using EuroQol 5-dimensions 5-levels (EQ-5D-5L) and the EuroQol-Visual Analogue Scales (EQ-VAS) instruments. A lower EQ-5D-5L utility mean score for each dimension and/or an overall lower utility score of EQ-5D-5L and EQ-VAS scores are intended to show poor HRQoL. Linear regression analysis was used to identify the association of HRQoL and other variables.

RESULTS

Out of the 422 samples approached, 402 (95.3%) participated in the study. Most of the participants (>85%) reported having moderate-to-severe problems in all five EQ dimensions. The overall EQ-5D-5L utility and EQ-VAS scores were 0.56 (±0.11) and 56.7 (±10.1), respectively. A higher body mass index (BMI) (p < 0.001), a higher number of medications (p = 0.037), a high level of blood glucose (p < 0.001), the presence of comorbidities and/or complications (p = 0.031), hypoglycaemia (p = 0.043) and taking insulin (p < 0.001) were associated with worsened HRQoL, whereas practicing self-monitoring of blood glucose (p = 0.002) and taking aspirin (p = 0.008) had a significant association with increased HRQoL.

CONCLUSION

This study concluded that the HRQoL of patients was compromised in all five measuring dimensions. The EQ-5D-5L utility and EQ-VAS scores were far lower than other findings. Clinical and medication-related variables, such as a higher BMI, a higher number of medications, the presence of comorbidities and/or complications, hypoglycaemia and insulin use were associated with poor HRQoL in patients with diabetes. As a result, interventions should be individualised and focused on determinant factors.

摘要

目的

本研究评估了糖尿病患者的健康相关生活质量(HRQoL)及其决定因素。

设计和设置

本研究为 2022 年 4 月至 7 月在埃塞俄比亚西北部选定医院的糖尿病随访诊所进行的基于机构的多中心前瞻性横断面研究设计。

参与者

所有符合条件的成年糖尿病患者。

主要观察指标

使用欧洲五维健康量表 5 维度 5 水平(EQ-5D-5L)和欧洲五维健康量表视觉模拟量表(EQ-VAS)评估 HRQoL。每个维度的 EQ-5D-5L 效用平均得分较低,或者 EQ-5D-5L 和 EQ-VAS 得分的整体效用得分较低,表明 HRQoL 较差。线性回归分析用于确定 HRQoL 与其他变量的关联。

结果

在 422 名接受调查的样本中,有 402 名(95.3%)参与了研究。大多数参与者(>85%)报告在所有五个 EQ 维度中都存在中度至重度问题。总体 EQ-5D-5L 效用和 EQ-VAS 得分分别为 0.56(±0.11)和 56.7(±10.1)。较高的体重指数(BMI)(p<0.001)、服用的药物数量较多(p=0.037)、血糖水平较高(p<0.001)、存在合并症和/或并发症(p=0.031)、低血糖(p=0.043)和使用胰岛素(p<0.001)与 HRQoL 恶化相关,而自我监测血糖(p=0.002)和使用阿司匹林(p=0.008)与 HRQoL 增加显著相关。

结论

本研究得出结论,糖尿病患者的 HRQoL 在所有五个测量维度都受到影响。EQ-5D-5L 效用和 EQ-VAS 得分远低于其他研究结果。BMI 较高、服用的药物数量较多、存在合并症和/或并发症、低血糖和胰岛素使用等临床和药物相关变量与糖尿病患者的 HRQoL 较差有关。因此,干预措施应个体化,并侧重于决定因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75aa/9884918/67864cdc08da/bmjopen-2022-068518f01.jpg

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