Abstract
AimsGeneric, preference-based measures of health-related quality of life (HRQoL) are a common input to the economic evaluation of new health technologies. As such, it is important to explore what characteristics of patients with Type 1 diabetes might impact scores on such measures.MethodsThis study utilizes baseline data from a cluster-randomized trial that recruited patients with Type 1 diabetes at six centers across Ireland. Health-related quality of life was assessed using the three-level EuroQol EQ-5D (EQ-5D) measure. Patients’ responses to individual dimensions of the EQ-5D were explored. To see which patient factors influenced EQ-5D scores, multivariate regression analysis was conducted with EQ-5D scores as the outcome variable.ResultsData was available for 437 Type 1 diabetes patients. The median age of these patients was 40 (IQR: 31-49) years and 53.8% were female. Overall, patients reported a high HRQoL based on EQ-5D scores (0.87 (SD: 0.19). Fifty-four percent of patients reported a perfect HRQoL. For those that reported problems, the most common dimension was the anxiety/depression dimension of the EQ-5D (29.6%). In the multivariate regression analysis, self-reported mental illness (− 0.22 (95% CI: -0.34, − 0.10)) and being unemployed (− 0.07 (95% CI: -0.13, − 0.02)) were negatively associated with EQ-5D scores (p < 0.05). The influence of self-reported mental illness was persistent in sensitivity analyses.ConclusionsThe study results indicate that patients with Type 1 diabetes report a high HRQoL based on responses to the EQ-5D. However, there are a substantial number of Type 1 diabetes patients that report problems in the anxiety/depression dimension, which may provide avenues to improve patients’ HRQoL.Trial registrationCurrent Controlled Trials ISRCTN79759174.
Highlights
The global incidence of Type 1 diabetes has been rising and is predicted to further increase in the foreseeable future [1]
Statistical analysis We examined the distribution of EQ-5D index scores and EQ-Visual analogue scale (VAS) scores which revealed a skewed distribution for the EQ-5D scores, similar to what has been reported elsewhere [16]
A sensitivity analysis was performed, given these distributional concerns with EQ-5D scores, whereby a binary outcome variable was created for those reporting ‘any problems’ and those reporting ‘no problems’ in EQ-5D scores to explore whether the same associations existed in Results This trial consisted of 437 patients with Type 1 diabetes from 6 centres across Ireland
Summary
The global incidence of Type 1 diabetes has been rising and is predicted to further increase in the foreseeable future [1]. Commensurate with this increase is the development and availability of new technologies for the monitoring and treatment of the disease [2]. Preference-based measures of health-related quality of life (HRQoL) are often used to assess these benefits in economic evaluation and, Existing literature for patients with Type 2 diabetes has found that obesity and the presence of diabetes-related complications were significant factors in determining patients EQ-5D scores [4]. Similar to results reported in patients with Type 2 diabetes, previous evidence suggests that diabetes-related
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