HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Online-Only Appendix All Versions of this Article: dc07-0499v1 30/10/2478    most recent Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Huang, E. S. Articles by Meltzer, D. O. Search for Related Content PubMed PubMed Citation Articles by Huang, E. S. Articles by Meltzer, D. O. Social Bookmarking                What's this?

Patient Perceptions of Quality of Life With Diabetes-Related Complications and Treatments

¹ Section of General Internal Medicine, Pritzker School of Medicine, University of Chicago, Chicago, Illinois
² Department of Family Medicine, Pritzker School of Medicine, University of Chicago, Chicago, Illinois

Address correspondence and reprint requests to Elbert S. Huang, MD, MPH, The University of Chicago, 5841 S. Maryland Ave., MC 2007, Chicago, IL 60637. E-mail: ehuang{at}medicine.bsd.uchicago.edu

OBJECTIVE—Understanding how individuals weigh the quality of life associated with complications and treatments is important in assessing the economic value of diabetes care and may provide insight into treatment adherence. We quantify patients’ utilities (a measure of preference) for the full array of diabetes-related complications and treatments.

RESEARCH DESIGN AND METHODS—We conducted interviews with a multiethnic sample of 701 adult patients living with diabetes who were attending Chicago area clinics. We elicited utilities (ratings on a 0–1 scale, where 0 represents death and 1 represents perfect health) for hypothetical health states by using time-tradeoff questions. We evaluated 9 complication states (e.g., diabetic retinopathy and blindness) and 10 treatment states (e.g., intensive glucose control vs. conventional glucose control and comprehensive diabetes care [i.e., intensive control of multiple risk factors]).

RESULTS—End-stage complications had lower mean utilities than intermediate complications (e.g., blindness 0.38 [SD 0.35] vs. retinopathy 0.53 [0.36], P < 0.01), and end-stage complications had the lowest ratings among all health states. Intensive treatments had lower mean utilities than conventional treatments (e.g., intensive glucose control 0.67 [0.34] vs. conventional glucose control 0.76 [0.31], P < 0.01), and the lowest rated treatment state was comprehensive diabetes care (0.64 [0.34]). Patients rated comprehensive treatment states similarly to intermediate complication states.

CONCLUSIONS—End-stage complications have the greatest perceived burden on quality of life; however, comprehensive diabetes treatments also have significant negative quality-of-life effects. Acknowledging these effects of diabetes care will be important for future economic evaluations of novel drug combination therapies and innovations in drug delivery.

Abbreviations: CEA, cost-effectiveness analysis

CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				E. S. Huang, Q. Zhang, N. Gandra, M. H. Chin, and D. O. Meltzer The Effect of Comorbid Illness and Functional Status on the Expected Benefits of Intensive Glucose Control in Older Patients with Type 2 Diabetes: A Decision Analysis Ann Intern Med, July 1, 2008; 149(1): 11 - 19. [Abstract] [Full Text] [PDF]