Patient-Reported Outcome Measures in Patients with Diabetes Mellitus: Findings from the Diabetes Landeck Cohort

Abstract

Introduction Maintaining and optimizing quality of life (QoL) is a central issue and one of the most important goals in therapy for patients with chronic diseases, such as diabetes mellitus (DM). Despite its importance, there is little data on the QoL of patients with DM in Austria. The objective of this study was to extend an established population-based cohort, the Diabetes-Landeck cohort, by including patient-reported outcomes.

Methods We performed a survey on quality of life (QoL) and treatment satisfaction in patients from the Diabetes-Landeck cohort using the EQ-5D-5L, the problem areas in diabetes survey (PAID), and the diabetes treatment satisfaction questionnaire (DTSQ). Mean sum scores were calculated and compared between patient characteristic subgroups.

Results In total 58 patients were recruited, with a mean age of 63 years and a mean hemoglobin A1c (HbA1c) of 7.1%. The mean sum score of EQ-5D-5L was 92 (SD=10.6), and that of DTSQ and PAID were 32.2 (SD=6.6) and 10.8 (SD=11.6), respectively. Patients with obesity (body mass index ≥ 30 kg/m²) showed a statistically significant decreased mean sum score of EQ-5D-5L and a statistically significant increased mean sum score of DTSQ. Patients with HbA1c ≥7.5% showed a statistically significant decreased mean sum score of DTSQ.

Conclusion We observed patient-reported outcomes significantly associated with obesity and HbA1c, which could be used for targeted patient monitoring. Limited by small sample size and questions in generalizability, we strongly suggest the rollout of a larger study.

Keywords

Diabetes mellitus - quality of life - Austria - cohort

Publication History

Received: 22 July 2024

Accepted: 28 November 2024

Article published online:
20 January 2025

• References

• 1 International-Diabetes-Federation. IDF Diabetes Atlas, 10th ed. Brussels, Belgium: 2021
• 2 Wändell PE. Quality of life of patients with diabetes mellitus. An overview of research in primary health care in the Nordic countries. Scand J Prim Health Care 2005; 23: 68-74
• 3 Bradley C, Eschwège E, de Pablos-Velasco P. et al. Predictors of quality of life and other patient-reported outcomes in the PANORAMA multinational study of people with type 2 diabetes. Diabetes Care 2018; 41: 267-276
• 4 Jing X, Chen J, Dong Y. et al. Related factors of quality of life of type 2 diabetes patients: A systematic review and meta-analysis. Health Qual Life Outcomes 2018; 16: 189
• 5 Kulzer B, Lüthgens B, Landgraf R. et al. Diabetesbezogene belastungen, wohlbefinden und einstellung von menschen mit diabetes. Der Diabetologe 2015; 11: 211-218
• 6 Oluchi SE, Manaf RA, Ismail S. et al. Health related quality of life measurements for diabetes: A systematic review. Int J Environ Res Public Health 2021; 18: 9245
• 7 Rubin RR, Peyrot M. Quality of life and diabetes. Diabetes Metab Res Rev 1999; 15: 205-218
• 8 Davies MJ, D'Alessio DA, Fradkin J. et al. Management of hyperglycaemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia 2018; 61: 2461-2498
• 9 Busetto L, Luijkx KG, Elissen AM. et al. Intervention types a outcomes of integrated care for diabetes mellitus type 2: A systematic review. J Eval Clin Pract 2016; 22: 299-310
• 10 Saisho Y. Use of diabetes treatment satisfaction questionnaire in diabetes care: Importance of patient-reported outcomes. Int J Environ Res Public Health 2018; 15: 947
• 11 BMGF. Österreichische Diabetes-Strategie, Bundesministerium für Gesundheit und Frauen & Gesundheit Österreich. GmbH; Wien: 2017
• 12 Haslwanter V, Rochau U, Siebert U. et al. A population-based cohort of adult patients with diabetes mellitus in a western district of Austria: The Diabetes Landeck Cohort. Endocrinol Diabetes Metab 2023; 6: e395
• 13 Herdman M, Gudex C, Lloyd A. et al. Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res 2011; 20: 1727-1736
• 14 Polonsky WH, Anderson BJ, Lohrer PA. et al. Assessment of diabetes-related distress. Diabetes Care 1995; 18: 754-760
• 15 Bradley C. Diabetes Treatment Satifaction Questionnaire (DTSQ). In Bradley C, ed. Handbook of psychology and diabetes: A guide to psychological measurement in diabetes research and practise. pp. 111-132 London: Overseas Publishers Association; 1994
• 16 Harb B, Kubiak T, Roth R. Empirische Überprüfung der deutschen Fassung des Diabetes Treatment Satisfaction Questionnaire (DTSQ). Diabetologie und Stoffwechsel 2007; 2: P188
• 17 Snoek FJ, Pouwer F, Welch GW. et al. Diabetes-related emotional distress in Dutch and U.S. diabetic patients: Cross-cultural validity of the problem areas in diabetes scale. Diabetes Care 2000; 23: 1305-1309
• 18 Zhou T, Guan H, Wang L. et al. Health-related quality of life in patients with different diseases measured with the EQ-5D-5L: A systematic review. Front Public Health 2021; 9: 675523
• 19 Brooks R. EuroQol: The current state of play. Health Policy 1996; 37: 53-72
• 20 Group E EQ-5D-5L explained in about two minutes 2024 https://euroqol.org/
• 21 Hinz A, Kohlmann T, Stöbel-Richter Y. et al. The quality of life questionnaire EQ-5D-5L: Psychometric properties and normative values for the general German population. Qual Life Res 2014; 23: 443-447
• 22 Branca FNHL, T Die Herausforderung Adipositas und Strategien für ihre Bekämpfung in der Europäischen Region der WHO: Zusammenfassung. Denmark: Weltgesundheitsorganisation; 2007
• 23 StataCorp. 2023. Stata statistical software: Release 18. College Station: TX: StataCorp LLC;
• 24 Kolotkin RL, Andersen JR. A systematic review of reviews: Exploring the relationship between obesity, weight loss and health-related quality of life. Clin Obes 2017; 7: 273-289
• 25 Stuckey HL, Dellasega C, Graber NJ. et al. Diabetes nurse case management and motivational interviewing for change (DYNAMIC): Study design and baseline characteristics in the Chronic Care Model for type 2 diabetes. Contemp Clin Trials 2009; 30: 366-374
• 26 Kuniss N, Kramer G, Müller UA. et al. Diabetes related distress is high in inpatients with diabetes. Diabetol Metab Syndr 2021; 13: 40
• 27 Grigorescu ED, Lăcătușu CM, Creţu I. et al. Self-reported satisfaction to treatment, quality of life and general health of type 2 diabetes patients with inadequate glycemic control from North-Eastern Romania. Int J Environ Res Public Health 2021; 18: 3249
• 28 Motoda S, Watanabe N, Nakata S. et al. Motivation for treatment correlating most strongly with an increase in satisfaction with type 2 diabetes treatment. Diabetes Ther 2022; 13: 709-721
• 29 Hayashi I, Watanabe N, Nakata S. et al. Factors associated with treatment satisfaction in patients with type 2 diabetes mellitus using oral glucose-lowering agents: A cross-sectional study in urban districts in Japan. Endocr J 2018; 65: 1001-1009
• 30 Devlin NJ, Brooks R. EQ-5D and the EuroQol Group: Past, present and future. Appl Health Econ Health Policy 2017; 15: 127-137
• 31 Afshari S, Ameri H, Baharinya S. et al. Assessment of the properties of the EQ-5D-5L in patients with type 2 diabetes mellitus: A systematic review and meta-analysis. Expert Rev Pharmacoecon Outcomes Res 2022; 22: 351-364
• 32 Tang TS, Yusuf FLA, Polonsky WH. et al. Assessing quality of life in diabetes: II - Deconstructing measures into a simple framework. Diabetes Res Clin Pract 2017; 126: 286-302
• 33 Kulzer B, Krichbaum M, Hermanns N. Lebensqualität bei Diabetes mellitus. Quality of life in diabetes mellitus. InFo Diabetologie 2010; 4: 32-39
• 34 Kubiak T, Hermanns N, Krichbaum M. et al. Erfassung der diabetesbezogenen Therapiezufriedenheit mit der deutschsprachigen Fassung des Diabetes Treatment Satisfaction Questionnaire (DTSQ) – psychometrische Eigenschaften und Validierung. 2003 56.
• 35 Bradley C, Gamsu DS. Guidelines for encouraging psychological well-being: Report of a Working Group of the World Health Organization Regional Office for Europe and International Diabetes Federation European Region St Vincent Declaration Action Programme for Diabetes. Diabetic Med 1994; 11: 510-516