No consistent association between processes-of-care and health-related quality of life among patients with diabetes: a missing link?

Alejandra Casillas, Katia Iglesias, Aline Flatz, Bernard Burnand, Isabelle Peytremann-Bridevaux, Alejandra Casillas, Katia Iglesias, Aline Flatz, Bernard Burnand, Isabelle Peytremann-Bridevaux

Abstract

Purpose: Health-related quality of life (HRQoL) is considered a representative outcome in the evaluation of chronic disease management initiatives emphasizing patient-centered care. We evaluated the association between receipt of processes-of-care (PoC) for diabetes and HRQoL.

Methods: This cross-sectional study used self-reported data from non-institutionalized adults with diabetes in a Swiss canton. Outcomes were the physical/mental composites of the short form health survey 12 (SF-12) physical composite score, mental composite score (PCS, MCS) and the Audit of Diabetes-Dependent Quality of Life (ADDQoL). Main exposure variables were receipt of six PoC for diabetes in the past 12 months, and the Patient Assessment of Chronic Illness Care (PACIC) score. We performed linear regressions to examine the association between PoC, PACIC and the three composites of HRQoL.

Results: Mean age of the 519 patients was 64.5 years (SD 11.3); 60% were male, 87% reported type 2 or undetermined diabetes and 48% had diabetes for over 10 years. Mean HRQoL scores were SF-12 PCS: 43.4 (SD 10.5), SF-12 MCS: 47.0 (SD 11.2) and ADDQoL: -1.6 (SD 1.6). In adjusted models including all six PoC simultaneously, receipt of influenza vaccine was associated with lower ADDQoL (β=-0.4, p≤0.01) and foot examination was negatively associated with SF-12 PCS (β=-1.8, p≤0.05). There was no association or trend towards a negative association when these PoC were reported as combined measures. PACIC score was associated only with the SF-12 MCS (β=1.6, p≤0.05).

Conclusions: PoC for diabetes did not show a consistent association with HRQoL in a cross-sectional analysis. This may represent an effect lag time between time of process received and health-related quality of life. Further research is needed to study this complex phenomenon.

Keywords: Chronic Disease Management; Clinical Care; Patient-Oriented Research; Quality of Life.

References

    1. International Diabetes Federation. IDF Diabetes Atlas, 6th edn. Brussels, Belgium: International Diabetes Federation, 2013.
    1. Mokdad AH, Bowman BA, Ford ES et al. . The continuing epidemics of obesity and diabetes in the United States. JAMA 2001;286:1195–200. 10.1001/jama.286.10.1195
    1. Grandy S, Fox KM. Change in health status (EQ-5D) over 5 years among individuals with and without type 2 diabetes mellitus in the SHIELD longitudinal study. Health Qual Life Outcomes 2012;10:99 10.1186/1477-7525-10-99
    1. Hoyert, DL. Xu, J. Center for Disease Control: Leading causes of death. National Vital Statistics Reports, Volume 61, Number 6. Oct 2012.
    1. Rubin RR, Peyrot M. Quality of Life and diabetes. Diabetes Metab Res Rev 1999;15:205–18. 10.1002/(SICI)1520-7560(199905/06)15:3<205::AID-DMRR29>;2-O
    1. AHRQ Health Care Innovations Exchange: innovations and tools to improve quality and reduce disparities, 2013.
    1. Gibbons E, Fitzpatrick R. A structured review of patient-reported outcome measures for people with diabetes: an update 2009. University of Oxford, 2009. .
    1. Collins MM. Quality of life and quality of care in patients with diabetes experiencing different models of care. Diabetes Care 2009;32:603–5. 10.2337/dc08-1169
    1. McEwen LN, Kim C, Haan MN et al. . Are health-related quality-of-life and self-rated health associated with mortality? Insights from Translating Research Into Action for Diabetes (TRIAD). Prim Care Diabetes 2009;3:37–42. 10.1016/j.pcd.2009.01.001
    1. Lau CY, Qureshi AK, Scott SG. Association between glycaemic control and quality of life in diabetes mellitus. J Postgrad Med 2004;50:189–93; discussion 94.
    1. de Beaufort CE, Reunanen A, Raleigh V et al. . European Union diabetes indicators: fact or fiction? Eur J Public Health 2003;13(3 Suppl):51–4. 10.1093/eurpub/13.suppl_3.51
    1. Fleming BB, Greenfield S, Engelgau MM et al. . The Diabetes Quality Improvement Project: moving science into health policy to gain an edge on the diabetes epidemic. Diabetes Care 2001;24:1815–20. 10.2337/diacare.24.10.1815
    1. McClain MR, Wennberg DE, Sherwin RW et al. . Trends in the diabetes quality improvement project measures in Maine from 1994 to 1999. Diabetes Care 2003;26:597–601. 10.2337/diacare.26.3.597
    1. De Berardis G, Pellegrini F, Franciosi M et al. . QuED (Quality of Care and Outcomes in Type 2 Diabetes) Study Group. Quality of diabetes care predicts the development of cardiovascular events: results of the QuED study. Nutr Metab Cardiovasc Dis 2008;18:57–65. 10.1016/j.numecd.2006.04.009
    1. Nordwall M, Arnqvist HJ, Bojestig M et al. . Good glycemic control remains crucial in prevention of late diabetic complications—the Linkoping Diabetes Complications Study. Pediatr Diabetes 2009;10:168–76. 10.1111/j.1399-5448.2008.00472.x
    1. Nicolucci A, Greenfield S, Mattke S. Selecting indicators for the quality of diabetes care at the health systems level in OECD countries. Int J Qual Health Care 2006;18(Suppl 1):26–30. 10.1093/intqhc/mzl023
    1. Peytremann-Bridevaux I, Santschi V, Collet TH et al. . Community-based pharmacies: an opportunity to recruit patients? Int J Public Health 2013;58:319–22. 10.1007/s00038-012-0383-8
    1. Zuercher E, Casillas A, Hagon-Traub I et al. . Baseline data of a population-based cohort of patients with diabetes in Switzerland (CoDiab-VD). Swiss Med Wkly 2014;144:w13951 10.4414/smw.2014.13951
    1. Beaton DE. Evaluating changes in health status: reliability and responsiveness of five generic health status measures in workers with musculoskeletal disorders. J Clin Epidemiol 1997;50:79–93. 10.1016/S0895-4356(96)00296-X
    1. Bradley C, Todd C, Gorton T et al. . The Development of an Individualized Questionnaire Measure of Perceived Impact of Diabetes on Quality of Life: The ADDQoL. Qual Life Res 1999;8:79–91. 10.1023/A:1026485130100
    1. Ostini R, Dower J, Donald M. The Audit of Diabetes-Dependent Quality of Life 19 (ADDQoL): feasibility, reliability and validity in apopulation-based sample of Australian adults. Qual Life Res 2012;21:1471–7. 10.1007/s11136-011-0043-0
    1. El Achhab Y, Neijari C, Chikri M et al. . Disease-specific health-related quality of life instruments among adult diabetics: a systematic review. Diabetes Res Clin Pract 2008;80:171–84. 10.1016/j.diabres.2007.12.020
    1. Speight J, Reaney MD, Barnard KD. Not all roads lead to Rome-a review of quality of life measurement in adults with diabetes. Diabet Med 2009;26:315–27. 10.1111/j.1464-5491.2009.02682.x
    1. Ackermann RT, Thompson TJ, Selby JV et al. . Is the number of documented diabetes process-of-care indicators associated with cardiometabolic risk factor levels, patient satisfaction, or self-rated quality of diabetes care? The Translating Research into Action for Diabetes (TRIAD) study. Diabetes Care 2006;29:2108–13. 10.2337/dc06-0633
    1. Nolan T, Berwick DM. All-or-none measurement raises the bar on performance. JAMA 2006;295:1168–70. 10.1001/jama.295.10.1168
    1. Glasgow RE, Whitesides H, Nelson CC et al. . Use of the Patient Assessment of Chronic Illness Care (PACIC) with diabetic patients: relationship to patient characteristics, receipt of care, and self-management. Diabetes Care 2005;28:2655–61. 10.2337/diacare.28.11.2655
    1. Ko KD, Kim BH, Oh SI et al. . What are patient factors associated with the quality of diabetes care?: results from the Korean National Health and Nutrition Examination Survey. BMC Public Health 2012;12:689 10.1186/1471-2458-12-689
    1. Lutfiyya MN, McCullough JE, Mitchell L et al. . Adequacy of diabetes care for older US rural adults: a cross-sectional population based study using 2009 BRFSS data. BMC Public Health 2011;11:940 10.1186/1471-2458-11-940
    1. Wexler DJ, Grant RW, Wittenberg E et al. . Correlates of health-related quality of life in type 2 diabetes. Diabetologia 2006;49:1489–97. 10.1007/s00125-006-0249-9
    1. Matthews DR. The natural history of diabetes-related complications: the UKPDS experience. United Kingdom Prospective Diabetes Study. Diabetes Obes Metab 1999;1(Suppl 2):S7–13. 10.1046/j.1463-1326.1999.0010s2007.x
    1. Saaddine JB, Cadwell B, Gregg EW et al. . Improvements in diabetes processes of care and intermediate outcomes: United States, 1988–2002. Ann Intern Med 2006;144:465–74. 10.7326/0003-4819-144-7-200604040-00005
    1. Khanna A, Bush AL, Swint JM et al. . Hemoglobin A1c improvements and better diabetes-specific quality of life among participants completing diabetes self-management programs: a nested cohort study. Health Qual Life Outcomes 2012;10:48 10.1186/1477-7525-10-48
    1. Garcia-Morales E, Lazaro-Martinez JL, Martinez-Hernandez D et al. . Impact of diabetic foot related complications on the health related quality of life (HRQol) of patients—a regional study in Spain. Int J Low Extrem Wounds 2011;10:6–11. 10.1177/1534734611400257
    1. Maatouk I, Wild B, Wesche D et al. . Temporal predictors of health-related quality of life in elderly people with diabetes: results of a German cohort study. PLoS ONE 2012;7:e31088 10.1371/journal.pone.0031088
    1. Harris MI. Health care and health status and outcomes for patients with type 2 diabetes. Diabetes Care 2000;23:754–8. 10.2337/diacare.23.6.754
    1. Sidorenkov G, Haaijer-Ruskamp FM, de Zeeuw D et al. . Review: relation between quality-of-care indicators for diabetes and patient outcomes: a systematic literature review. Med Care Res Rev 2011;68:263–89. 10.1177/1077558710394200
    1. Miller DR, Pogach L. Longitudinal approaches to evaluate health care quality and outcomes: the Veterans Health Administration diabetes epidemiology cohorts. J Diabetes Sci Technol 2008;2:24–32. 10.1177/193229680800200105
    1. Thompson W, Wang H, Xie M et al. . Assessing quality of diabetes care by measuring longitudinal changes in hemoglobin A1c in the Veterans Health Administration. Health Serv Res 2005;40(6 Pt 1):1818–35. 10.1111/j.1475-6773.2005.00439.x
    1. Firmann M, Mayor V, Vidal PM et al. . The CoLaus study: a population-based study to investigate the epidemiology and genetic determinants of cardiovascular risk factors and metabolic syndrome. BMC Cardiovasc Disord 2008;8:1–11 10.1186/1471-2261-8-6
    1. Collet T-H, Taffé P, Bordet J et al. . Comparison of diabetes quality of care indicators as reported by patients and primary care physicians. Swiss Society of Internal Medicine, May 2013: IUMSP, 2013.

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