Predictors of Health-related Quality of Life and Self-care in a Large Sample of Spanish Adults with Diabetes Mellitus
Clara Marcuello
Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, IdISSC, Spain
Carmen Montañez
Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, IdISSC, Spain
Borja Muñoz
Department of Medicine II, Universidad Complutense, Madrid, Spain
Ester Montenegro
Department of Medicine II, Universidad Complutense, Madrid, Spain
Isabel Calvo
Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, IdISSC, Spain
Consuelo Auñón
Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, IdISSC, Spain
Amparo Sabaté
Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, IdISSC, Spain
Laura del Valle
Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, IdISSC, Spain
Manuel Fuentes Ferrer
Department of Preventive Medicine, Hospital Clínico San Carlos, Spain
Carla Assaf-Balut
Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, IdISSC, Spain and Department of Medicine II, Universidad Complutense, Madrid, Spain
Isabelle Runkle
Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, IdISSC, Spain and Department of Medicine II, Universidad Complutense, Madrid, Spain
Miguel Angel Rubio
Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, IdISSC, Spain and Department of Medicine II, Universidad Complutense, Madrid, Spain
Alfonso Luis Calle-Pascual *
Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, IdISSC, Spain and Department of Medicine II, Universidad Complutense, Madrid, Spain
*Author to whom correspondence should be addressed.
Abstract
Objective: To assess health-related quality of life (HRQoL) and self – care behaviors in a large sample of diabetic patients (DPts) and to examine which patients’ characteristics influence on them.
Methods: This cross - sectional study included 1,039 DPts (561/478, Men/Women, 156/883 DM1/DM2, mean age 62±15 years old; mean diabetes duration 15±10 years) evaluated in a diabetes (DM) specialized outpatient office, at St Carlos Hospital, in Madrid, from 2012 to 2014. HRQoL was assessed with the EuroQoL- Visual Analogue Scale (EQoL-VAS) and the Diabetes Quality of Life Score (DQoL). Treatment adherence was evaluated using the Self-Care Inventory-revised (SCI- r). Multiple logistic regression analysis were used to examine the relationship between HRQoL, adherence to treatment and several demographic and clinical patients’ characteristics.
Results: A lower quality of life was associated with the female gender, the presence of chronic complications and a poor glycemic control (all p < 0, 05). After adjustment for confounders, obese middle-aged men showed the lowest adherence to treatment. However, women with a prolonged duration of the DM (> 15 years) and DPts receiving insulin treatment showed a better DM self-care (p <0.05).
Conclusions and Implications: The duration of the DM, metabolic control, the type of therapy, and the presence of chronic complications are important determinants of HRQoL and treatment adherence in patients with DM, and should be taken into account when treating DPts. Data obtained could be useful to plan patient-based health decisions.
Keywords: Health-related quality of life, diabetes quality of life score, EuroQoL- visual analogue scale, self-care inventory-revised, diabetes mellitus, diabetes complications.