The health-related utility and health-related quality of life of hospital-treated subjects with type 1 or type 2 diabetes with particular reference to differing severity of peripheral neuropathy.

Full Abstract

AIMS/HYPOTHESIS: We characterised symptom severity of diabetic peripheral neuropathy (DPN) in people with diabetes, and correlated this with health-related utility and health-related quality of life. MATERIALS AND METHODS: The study was undertaken in Cardiff and the Vale of Glamorgan, Wales. A postal survey was mailed to a random sample of subjects identified as having diabetes. Data were collected on the symptoms of neuropathy using the Neuropathic Total Symptom Score (self-administered) (NTSS-6-6A) and on quality of life using the Quality of Life in Diabetes Neuropathy Instrument (QoL-DN), EueroQoL five dimensions (EQ5D) and Short Form 36 (SF36). Other information, such as demographics and self-reported drug use, was also collected. The anonymised data were linked to routine inpatient and outpatient healthcare data. RESULTS: Responses were received from 1,298 patients. For patients with a clinically confirmed diagnosis of DPN, the mean NTSS-6-SA score was 6.16 vs 3.19 in patients without DPN (p<0.001). Four categories of severity were defined, ranging from none to severe. All quality of life measures showed a deterioration between these groups: the EQ5D(index) fell from an average of 0.81 in those without symptoms to 0.25 in those with severe symptoms, the SF36 general health profile fell from 59.9 to 25.5 (p<0.001) and the QoL-DN increased from 25.8 to 48.1 (p<0.001). Multivariate models also demonstrated that this relationship remained after controlling for other factors. CONCLUSIONS/INTERPRETATION: This study demonstrated that severity of DPN symptoms was predictive of poor health-related utility and decreased quality of life. Furthermore, it provides detailed utility data for economic evaluation of treatment of typical diabetes-related morbidity states. Reducing DPN morbidity should be a priority.

Author information

Author/s: Currie, C J (CJ); Poole, C D (CD); Woehl, A (A); Morgan, C Ll (CL); Cawley, S (S); Rousculp, M D (MD); Covington, M T (MT); Peters, J R (JR);

Affiliation: Department of Medicine, School of Medicine, Cardiff University, Cardiff, UK. currie(-atsign-)cardiff.ac.uk

Journal and publication information

Publication Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't

Journal: Diabetologia (Diabetologia), published in Germany. (Language: eng)

Reference: 2006-Oct; vol 49 (issue 10) : pp 2272-80

Dates: Created 2006/09/06; Completed 2007/03/26;

PMID: 16944094, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

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