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Health-related quality of life and health utilities in insulin-treated type 2 diabetes: the impact of related comorbidities/complications

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  • John Yfantopoulos

    (National and Kapodistrian University of Athens)

  • Athanasios Chantzaras

    (National and Kapodistrian University of Athens)

Abstract

Objective To evaluate the impact of multiple comorbidities/complications on health-related quality of life (HRQoL) and health utilities in insulin-treated type 2 diabetes (T2DM). Methods In a non-interventional, epidemiological study, data were collected from medical records and via interviews for 938 subjects from various geographical areas of Greece. HRQoL and health utilities were explored with the EQ-5D-5L. Univariate associations were evaluated with the Mann–Whitney and Kruskal–Wallis tests for continuous and Chi-squared tests for nominal variables, and binary logistic regressions were employed to obtain marginal effects. Employing a split sample approach, various specifications of ordinary least squares regression models were evaluated in terms of goodness of fit, model specification, shrinkage and predictive and discriminative performance, to select the best model for mapping health utilities using the whole dataset. Results Overall, the most important factors of impaired HRQoL and health utilities were higher age, female gender, obesity, poor glycemic control and increased duration of insulin treatment. History and increasing concurrence of all complications assessed were associated with exacerbated HRQoL problems, decreased health utilities and diminished health state, although it was not always statistically significant. The highest disutilities were associated with stroke (− 0.082), diabetic retinopathy (− 0.066), diabetic neuropathy (− 0.051) and severe hypoglycemia (− 0.050). Conclusions The deleterious impact of comorbidities on insulin-dependent T2DM subjects’ HRQoL has been confirmed and clinicians should adapt the priorities of disease management accordingly. The derived health utility estimates may be valuable for conducting economic evaluations of interventions in the area of T2DM when data are not available.

Suggested Citation

  • John Yfantopoulos & Athanasios Chantzaras, 2020. "Health-related quality of life and health utilities in insulin-treated type 2 diabetes: the impact of related comorbidities/complications," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(5), pages 729-743, July.
  • Handle: RePEc:spr:eujhec:v:21:y:2020:i:5:d:10.1007_s10198-020-01167-y
    DOI: 10.1007/s10198-020-01167-y
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    References listed on IDEAS

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    1. John N. Yfantopoulos & Athanasios E. Chantzaras, 2017. "Validation and comparison of the psychometric properties of the EQ-5D-3L and EQ-5D-5L instruments in Greece," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(4), pages 519-531, May.
    2. David G. T. Whitehurst & Stirling Bryan & Martyn Lewis, 2011. "Systematic Review and Empirical Comparison of Contemporaneous EQ-5D and SF-6D Group Mean Scores," Medical Decision Making, , vol. 31(6), pages 34-44, November.
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    4. Eleanor M. Pullenayegum & Jean-Eric Tarride & Feng Xie & Daria O’Reilly, 2011. "Calculating Utility Decrements Associated With an Adverse Event," Medical Decision Making, , vol. 31(6), pages 790-799, November.
    5. Paul Dolan & Claire Gudex & Paul Kind & Alan Williams, 1995. "A social tariff for EuroQol: results from a UK general population survey," Working Papers 138chedp, Centre for Health Economics, University of York.
    6. Philip Clarke & Alastair Gray & Rury Holman, 2002. "Estimating Utility Values for Health States of Type 2 Diabetic Patients Using the EQ-5D (UKPDS 62)," Medical Decision Making, , vol. 22(4), pages 340-349, August.
    7. 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.
    8. Nick Kontodimopoulos & Evelina Pappa & Zinovia Chadjiapostolou & Eleni Arvanitaki & Angelos Papadopoulos & Dimitris Niakas, 2012. "Comparing the sensitivity of EQ-5D, SF-6D and 15D utilities to the specific effect of diabetic complications," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(1), pages 111-120, February.
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    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 27th July 2020
      by Chris Sampson in The Academic Health Economists' Blog on 2020-07-27 11:00:01

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    More about this item

    Keywords

    Health-related quality of life; Health utilities; Type 2 diabetes; Mapping; EQ-5D; Greece;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • C1 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods and Methodology: General

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