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The Impact of Diabetes-Related Complications on Preference-Based Measures of Health-Related Quality of Life in Adults with Type I Diabetes

Author

Listed:
  • Tessa Peasgood
  • Alan Brennan
  • Peter Mansell
  • Jackie Elliott
  • Hasan Basarir
  • Jen Kruger

Abstract

Introduction . This study estimates health-related quality of life (HRQoL) or utility decrements associated with type 1 diabetes mellitus (T1DM) using data from a UK research program on the Dose Adjustment For Normal Eating (DAFNE) education program. Methods . A wide range of data was collected from 2341 individuals who undertook a DAFNE course in 2009–2012, at baseline and for 2 subsequent years. We use fixed- and random-effects linear models to generate utility estimates for T1DM using different instruments: EQ-5D, SF-6D, and EQ-VAS. We show models with and without controls for HbA1c and depression, which may be endogenous (if, for example, there is reverse causality in operation). Results . We find strong evidence of an unobserved individual effect, suggesting the superiority of the fixed-effects model. Depression shows the greatest decrement across all the models in the preferred fixed-effects model. The fixed-effects EQ-5D model also finds a significant decrement from retinopathy, body mass index, and HbA1c (%). Estimating a decrement using the fixed-effects model is not possible for some conditions where there are few new cases. In the random-effects model, diabetic foot disease shows substantial utility decrements, yet these are not significant in the fixed-effects models. Conclusion . Utility decrements have been calculated for a wide variety of health states in T1DM that can be used in economic analyses. However, despite the large data set, the low incidence of several complications leads to uncertainty in calculating the utility weights. Depression and diabetic foot disease result in a substantial loss in HRQoL for patients with T1DM. HbA1c (%) appears to have an independent negative impact on HRQoL, although concerns remain regarding the potential endogeneity of this variable.

Suggested Citation

  • Tessa Peasgood & Alan Brennan & Peter Mansell & Jackie Elliott & Hasan Basarir & Jen Kruger, 2016. "The Impact of Diabetes-Related Complications on Preference-Based Measures of Health-Related Quality of Life in Adults with Type I Diabetes," Medical Decision Making, , vol. 36(8), pages 1020-1033, November.
    • Handle: RePEc:sae:medema:v:36:y:2016:i:8:p:1020-1033
    DOI: 10.1177/0272989X16658660
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    References listed on IDEAS

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    1. Adrian Bagust & Sophie Beale, 2005. "Modelling EuroQol health‐related utility values for diabetic complications from CODE‐2 data," Health Economics, John Wiley & Sons, Ltd., vol. 14(3), pages 217-230, March.
    2. Jeffrey M Wooldridge, 2010. "Econometric Analysis of Cross Section and Panel Data," MIT Press Books, The MIT Press, edition 2, volume 1, number 0262232588, December.
    3. Maria Alva & Alastair Gray & Borislava Mihaylova & Philip Clarke, 2014. "The Effect Of Diabetes Complications On Health‐Related Quality Of Life: The Importance Of Longitudinal Data To Address Patient Heterogeneity," Health Economics, John Wiley & Sons, Ltd., vol. 23(4), pages 487-500, April.
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    1. Adedokun Oluwafemi Ojelabi & Afolabi Elijah Bamgboye & Jonathan Ling, 2019. "Preference-based measure of health-related quality of life and its determinants in sickle cell disease in Nigeria," PLOS ONE, Public Library of Science, vol. 14(11), pages 1-16, November.
    2. Michelle Tew & Michael Willis & Christian Asseburg & Hayley Bennett & Alan Brennan & Talitha Feenstra & James Gahn & Alastair Gray & Laura Heathcote & William H. Herman & Deanna Isaman & Shihchen Kuo , 2022. "Exploring Structural Uncertainty and Impact of Health State Utility Values on Lifetime Outcomes in Diabetes Economic Simulation Models: Findings from the Ninth Mount Hood Diabetes Quality-of-Life Chal," Medical Decision Making, , vol. 42(5), pages 599-611, July.

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