Abstract
BackgroundThe objective of this study was to investigate the association between ethnicity and health related quality of life (HRQoL) in patients with type 2 diabetes.MethodsThe EuroQol EQ-5D measure was administered to 1,978 patients with type 2 diabetes in the UK Asian Diabetes Study (UKADS): 1,486 of south Asian origin (Indian, Pakistani, Bangladeshi or other south Asian) and 492 of white European origin. Multivariate regression using ordinary least square (OLS), Tobit, fractional logit and Censored Least Absolutes Deviations estimators was used to estimate the impact of ethnicity on both visual analogue scale (VAS) and utility scores for the EuroQol EQ-5D.ResultsMean EQ-5D VAS and utility scores were lower among south Asians with diabetes compared to the white European population; the unadjusted effect on the mean EQ-5D VAS score was −7.82 (Standard error [SE] = 1.06, p < 0.01) and on the EQ-5D utility score was −0.06 (SE = 0.02, p < 0.01) (OLS estimator). After controlling for socio-demographic and clinical confounders, the adjusted effect on the EQ-5D VAS score was −9.35 (SE = 2.46, p < 0.01) and on the EQ-5D utility score was 0.06 (SE = 0.04), although the latter was not statistically significant.ConclusionsThere was a large and statistically significant association between south Asian ethnicity and lower EQ-5D VAS scores. In contrast, there was no significant difference in EQ-5D utility scores between the south Asian and white European sub-groups. Further research is needed to explain the differences in effects on subjective EQ-5D VAS scores and population-weighted EQ-5D utility scores in this context.
Highlights
The objective of this study was to investigate the association between ethnicity and health related quality of life (HRQoL) in patients with type 2 diabetes
There is evidence to suggest that the prevalence, disease progression and treatment outcomes for people with type 2 diabetes vary significantly between ethnic groups [5,6,7,8,9], but very little research has been undertaken to date to directly assess the extent to which ethnicity impacts on HRQoL in adults with diabetes
The York A1 tariff set was derived from a survey of the UK general population (n = 3337) which used the time trade-off valuation method to estimate utility scores for a subset of 45 EQ-5D health states, with the remainder of the EQ-5D health states subsequently valued through the estimation of a multivariate model [17]
Summary
The objective of this study was to investigate the association between ethnicity and health related quality of life (HRQoL) in patients with type 2 diabetes. There is evidence to suggest that the prevalence, disease progression and treatment outcomes for people with type 2 diabetes vary significantly between ethnic groups [5,6,7,8,9], but very little research has been undertaken to date to directly assess the extent to which ethnicity impacts on HRQoL in adults with diabetes. This, combined with differences in the black and minority ethnic (BME) populations studied, have resulted in both negative [5,6,7,9,10,11] and positive [12,13,14] associations being reported between ethnicity and HRQoL. If there are ethnic differences in how a disease such as diabetes affects HRQoL, this should be taken into account when considering the introduction of new interventions on cost-effectiveness grounds
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