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Estimation of the impact of diabetes-related complications on health utilities for patients with type 2 diabetes in Ontario, Canada

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Abstract

Objectives

The goal of this study was to analyze health-related quality of life (HRQL) data from a Canadian population with type 2 diabetes in order to estimate the disutility associated with experiencing a diabetes-related complication.

Methods

The EQ-5D, a standardized instrument for use as a measure of health outcome, was administered to 1,147 patients in Hamilton, Ontario, with type 2 diabetes. After controlling for age, gender, and duration of diabetes, changes in utility values were estimated by regressing the EQ-5D scores onto binary indicators for the presence of an event. The primary method of analysis was Ordinary Least Squares (OLS) and due to concerns over non-Normality, bootstrap standard errors (SE) were calculated.

Results

The analysis included 1,143 participants. Based on the OLS model, reductions in HRQL were associated with duration of diabetes (−0.0015, SE = 0.0006), experiencing a myocardial infarction (MI) (−0.059, SE = 0.017), amputation (−0.063, SE = 0.059), stroke (−0.046, SE = 0.023), and kidney failure (−0.102, SE = 0.047).

Conclusion

This study estimated the reductions in HRQL associated with several important complications commonly experienced in patients with diabetes. The greatest impacts on HRQL were associated with kidney failure and MI. The utility values calculated here can be used to assess the outcome of interventions that reduce these diabetes-related complications and will have a useful impact on future economic evaluations of diabetes management strategies in Canada.

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References

  1. Canadian Diabetes Association (2009). An economic tsunami: The cost of diabetes in Canada. Available: URL: http://www.diabetes.ca/economicreport/. Accessed 5 Sept 2010.

  2. Grundy, S. M., Benjamin, I. J., Burke, G. L., Chait, A., Eckel, R. H., Howard, B. V., et al. (1999). Diabetes and cardiovascular disease: A statement for healthcare professionals from the American heart association. Circulation, 100(10), 1134–1146.

    PubMed  CAS  Google Scholar 

  3. Sobel, B. E., & Schneider, D. J. (2005). Cardiovascular complications in diabetes mellitus. Current Opinion in Pharmacology, 5(2), 143–148.

    Article  PubMed  CAS  Google Scholar 

  4. Clarke, P., Gray, A., & Holman, R. (2002). Estimating utility values for health states of type 2 diabetic patients using the EQ-5D (UKPDS 62). Medical Decision Making, 22(4), 340–349.

    PubMed  Google Scholar 

  5. Holmes, J., Mcgill, S., Kind, P., Bottomley, J., Gillam, S., & Murhpy, M. (2000). Health-related quality of life in type 2 diabetes. Value Health, 3(Suppl 1), S47–S51.

    Article  Google Scholar 

  6. Koopmanschap, M. (2002). Coping with type II diabetes: The patient’s perspective. Diabetologia, 45(7), S18–S22.

    PubMed  CAS  Google Scholar 

  7. Redekop, W. K., Koopmanschap, M. A., Stolk, R. P., Rutten, G. E., Wolffenbuttel, B. H., & Niessen, L. W. (2002). Health-related quality of life and treatment satisfaction in Dutch patients with type 2 diabetes. Diabetes Care, 25(3), 458–463.

    Article  PubMed  Google Scholar 

  8. Sullivan, P. W., & Ghushchyan, V. (2006). Preference-based EQ-5D index scores for chronic conditions in the United States. Medical Decision Making, 26(4), 410–420.

    Article  PubMed  Google Scholar 

  9. MacKeigan, L. D., & Pathak, D. S. (1992). Overview of health-related quality-of-life measures. American Journal of Hospital Pharmacy, 49(9), 2236–2245.

    PubMed  CAS  Google Scholar 

  10. Anderson, R. M., Fitzgerald, J. T., Wisdom, K., Davis, W. K., & Hiss, R. G. (1997). A comparison of global versus disease-specific quality-of-life measures in patients with NIDDM. Diabetes Care, 20(3), 299–305.

    Article  PubMed  CAS  Google Scholar 

  11. de Visser, C. L., Bilo, H. J., Groenier, K. H., de Visser, W., & Jong Meyboom-de, B. (2002). The influence of cardiovascular disease on quality of life in type 2 diabetics. Quality of Life Research, 11(3), 249–261.

    Article  PubMed  Google Scholar 

  12. Feeny, D., Barr, R. D., Furlong, W., et al. (1991). Quality of life of the treatment process in pediatric oncology: An approach to measurement. In D. Osaba (Ed.), Effect of cancer on quality of life. Boca Raton, FL: CRC Press.

    Google Scholar 

  13. Torrance, G. W., Furlong, W., & Feeny, D. (2002). Health utility estimation. Expert Review of Pharmacoeconomics and Outcomes Research, 2(2), 99–108.

    Article  PubMed  Google Scholar 

  14. Bagust, A., & Beale, S. (2005). Modelling EuroQol health-related utility values for diabetic complications from CODE-2 data. Health Economics, 14(3), 217–230.

    Article  PubMed  Google Scholar 

  15. Coffey, J. T., Brandle, M., Zhou, H., Marriott, D., Burke, R., Tabaei, B. P., et al. (2002). Valuing health-related quality of life in diabetes. Diabetes Care, 25(12), 2238–2243.

    Article  PubMed  Google Scholar 

  16. The Diabetes Control and Complications Trial Research Group (1993). The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. New England Journal of Medicine, 329(14), 977–986.

    Article  Google Scholar 

  17. Maddigan, S. L., Feeny, D. H., & Johnson, J. A. (2003). A comparison of the health utilities indices mark 2 and mark 3 in type 2 diabetes. Medical Decision Making, 23(6), 489–501.

    Article  PubMed  Google Scholar 

  18. Maddigan, S. L., Feeny, D. H., & Johnson, J. A. (2005). Health-related quality of life deficits associated with diabetes and comorbidities in a Canadian national population health survey. Quality of Life Research, 14(5), 1311–1320.

    Article  PubMed  Google Scholar 

  19. Glasziou, P., Alexander, J., Beller, E., & Clarke, P. (2007). Which health-related quality of life score? A comparison of alternative utility measures in patients with type 2 diabetes in the ADVANCE trial. Health Qual Life Outcomes, 5, 21.

    Article  PubMed  Google Scholar 

  20. Diabetes Hamilton (2010). Diabetes Hamilton. Available from: URL: http://www.diabeteshamilton.ca/ndefault.php.

  21. Rabin, R., & de Charro, F. (2001). EQ-5D: A measure of health status from the EuroQol Group. Annals of Medicine, 33(5), 337–343.

    Article  PubMed  CAS  Google Scholar 

  22. Grandy, S., & Fox, K. M. (2008). EQ-5D visual analog scale and utility index values in individuals with diabetes and at risk for diabetes: Findings from the study to help improve early evaluation and management of risk factors leading to diabetes (SHIELD). Health Qual Life Outcomes, 6, 18.

    Article  PubMed  Google Scholar 

  23. National Institute for Clinical Excellence (2004). Guide to the methods of technology appraisal. London: National Institute for Clinical Excellence.

    Google Scholar 

  24. Wexler, D. J., Grant, R. W., Wittenberg, E., Bosch, J. L., Cagliero, E., Delahanty, L., et al. (2006). Correlates of health-related quality of life in type 2 diabetes. Diabetologia, 49(7), 1489–1497.

    Article  PubMed  CAS  Google Scholar 

  25. Brown, G. C., Brown, M. M., Sharma, S., Brown, H., Gozum, M., & Denton, P. (2000). Quality of life associated with diabetes mellitus in an adult population. Journal of Diabetes and its Complications, 14(1), 18–24.

    Article  PubMed  CAS  Google Scholar 

  26. Rubin, R. R., & Peyrot, M. (1999). Quality of life and diabetes. Diabetes Metabolism Research and Reviews, 15(3), 205–218.

    Article  PubMed  CAS  Google Scholar 

  27. Manuel, D. G., & Schultz, S. E. (2004). Health-related quality of life and health-adjusted life expectancy of people with diabetes in Ontario, Canada, 1996–1997. Diabetes Care, 27(2), 407–414.

    Article  PubMed  Google Scholar 

  28. Sharma, S., Oliver-Fernandez, A., Bakal, J., Hollands, H., Brown, G. C., & Brown, M. M. (2003). Utilities associated with diabetic retinopathy: Results from a Canadian sample. British Journal of Ophthalmology, 87(3), 259–261.

    Article  PubMed  CAS  Google Scholar 

  29. Johnson, J. A., Luo, N., Shaw, J. W., Kind, P., & Coons, S. J. (2005). Valuations of EQ-5D health states: are the United States and United Kingdom different? Medical Care, 43(3), 221–228.

    Article  PubMed  Google Scholar 

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Acknowledgements

Drs. Daria O'Reilly and Jean-Eric Tarride are supported by Ontario Ministry of Health Career Scientist Awards. This study was funded through a research grant from the Drug Innovation Fund within the Ontario Ministry of Health and Long-term Care.

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Authors and Affiliations

  1. Programs for Assessment of Technology in Health (PATH) Research Institute, St. Joseph’s Healthcare, 25 Main Street West, Suite 2000, Hamilton, ON, L8P 1H1, Canada

    Daria J. O’Reilly, Feng Xie, Gord K. Blackhouse, Jean-Eric Tarride, Jim Bowen & Ron A. Goeree

  2. Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada

    Daria J. O’Reilly, Feng Xie, Eleanor Pullenayegum, Janet Greb, Gord K. Blackhouse, Jean-Eric Tarride, Jim Bowen & Ron A. Goeree

  3. Department of Medicine and the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada

    Hertzel C. Gerstein

Authors
  1. Daria J. O’Reilly
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  2. Feng Xie
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  3. Eleanor Pullenayegum
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  7. Jean-Eric Tarride
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  9. Ron A. Goeree
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Correspondence to Daria J. O’Reilly.

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O’Reilly, D.J., Xie, F., Pullenayegum, E. et al. Estimation of the impact of diabetes-related complications on health utilities for patients with type 2 diabetes in Ontario, Canada. Qual Life Res 20, 939–943 (2011). https://doi.org/10.1007/s11136-010-9828-9

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  • DOI: https://doi.org/10.1007/s11136-010-9828-9

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