PDB41 DIABETIC PERIPHERAL NEUROPATHY: EVALUATION OF THE ASSOCIATION BETWEEN NEUROPATHIC SYMPTOMS (NTSS-6-SA)AND HEALTH CARE RESOURCE USE AND PRODUCTIVE LOSSES

Abstract

INTRODUCTION: Diabetes increases resource use, and complications add to costs. The purpose of this study was to characterise the association between increasing frequency and severity of the symptoms of diabetic peripheral neuropathy (SDPN), measured by the Neuropathy Total Symptom Score (NTSS)-6-SA, and health care resource use and loss of productivity. METHODS: A postal survey was mailed to subjects identified at random from hospital records as having either type-1 or Type-2 diabetes using the same methods as the Health Outcomes Data Repository (HODaR). Cross-sectional, univariate and multivariate analyses were used to test for the associations in this preliminary analysis of the first 604 responses. Where appropriate, four categories were used for cross-sectional analysis based on quartiles of the NTSS-6-SA scores, Q1 being the lowest score. RESULTS: The mean age of respondents was 64 years (IQR 55–73); 58% male and the mean duration of diabetes were 14 years (IQR 5–18). 24% reported no SDPN symptoms. The mean number of days in hospital in the previous year was: Q1 = 3.4 and Q4 = 8.3. Mean number of ambulatory care in last year: Q1 = 4.4 and Q4 = 10.6. Mean contacts with a GP or nurse in the community over six months: Q1 = 6.0 and Q4 = 14.3. Mean productive days lost in the previous six months: Q1 = 35 and Q4 = 128 (note: multiple categories can occur on the same day). In multivariate analysis adjusting for age and other complications, the NTSS-6-SA score remained highly significant. Using days in hospital since 1995 (10 years) as the dependent variable, there was an increase of 0.3 days per NTSS-6-SA unit (p < 0.001), and using outpatient attendances since 1997 as the dependent variable (8 years), there was an increase of 1.13 visits per unit (p < 0.001). CONCLUSIONS: There was a direct association between increase SDPN and increasing health care resource use; furthermore, increasing SDPN was associated with lost productivity.