57. A structured review of patient-reported measures in diabetes (405)
Anne Mackintosh, Research Officer, Unit of Health-Care Epidemiology, University of Oxford, Oxford, United Kingdom
Co author: Ray Fitzpatrick
anne.mackintosh@uhce.ox.ac.uk
Abstract:
Diabetes is a disorder of glucose metabolism caused by lack of the pancreatic hormone insulin, resulting in the accumulation of sugar in the bloodstream (hyperglycaemia). Symptoms include thirst, fatigue, weight loss, and excessive urination. Failure to metabolise glucose leads to excessive breakdown of fats in the body or ketosis which, if untreated, can lead to convulsions, coma, and death. Sufferers face the difficulties of self-management of a complex treatment regimen and severe long-term complications such as vascular disease, kidney and nerve damage, and blindness. In addition to the multiple physical impacts of diabetes and its treatment, psychosocial factors, such as depression, social support, and family relationships, can significantly affect the course of the disease. HRQoL measurement in diabetes is essential for making informed and rational choices amongst the wide range of treatments available, and tailoring these to the needs of individual patients. This presents a challenge, given the complexities of the condition and the plethora of measures developed for use with diabetes. A review completed in November 2006 offers some guidance. 495 records were retrieved from the PHI database using the term ‘diabet*’; supplementary searches yielded a further 73 records. When assessed against our inclusion criteria, 187 articles were retrieved and examined in full. Of these, 92 were included in the review.
We conclude that, for assessing broader aspects of health status in diabetes, the SF-36 clearly provides reliable insights. Where utility values are required, there is evidence to support the use of EQ-5D and HUI. It is normally recommended that a disease-specific measure be used in conjunction with a generic measure to assess problems relating to a particular condition. We found insufficient evidence to single out any one diabetes-specific instrument; however, ADDQoL, DHP, and DQOL warrant further evaluation. For all measures reviewed, evidence of responsiveness to change was limited.
Source of Funding: N/A
Amount in Funding: N/A
Biography:
Hospice nursing - Sir Michael Sobell House 1979-1983 Secretary/Librarian - University of Oxford Language Teaching Centre 1983-5 Oxfam 1985-1997: administration, middle management, situation analysis, strategic planning, public speaking/media work, writing Complementary therapist - shiatsu practitioner 1997-present Tai Chi tutor - Local Authority, including special needs, and private 1991-present Patient-reported Health Instruments Group (PHIG) 2000-present. Responsibilities include: developing protocol for updating PHIG bibliography; assessing & keywording records for inclusion in bibliography; revising search strategy and criteria for inclusion of bibliography records; contributing to systematic reviews of PHIs (writing, editing, literature searching)