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Marginal differences in health-related quality of life of diabetic patients with and without macrovascular comorbid conditions in the United States

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Abstract

Purpose

To examine and quantify, at the US national level, the marginal differences in health-related quality of life (HRQoL) of diabetic patients with and without macrovascular comorbid conditions (MaVCC).

Methods

Using the pooled Medical Expenditure Panel Survey (MEPS) 2001 and 2003 data, a nationally representative community-dwelling adult sample (age ≥ 18) was included in the study. HRQoL measures included the preference-based EQ-5D index, Euroqol visual analogue scale (EQ-VAS), SF-12 physical component summary (PCS), and SF-12 mental component summary (MCS). Given the censored distribution of the data, a two-part model was used to identify the relationship between MaVCC and the EQ-5D index after controlling for age, sex, race, ethnicity, education, income, employment status, health insurance, smoking status, diabetes severity, and comorbidities. Censored least absolute deviation and ordinary least square models were employed to analyze EQ-VAS and SF-12 PCS/MCS, respectively.

Results

Compared to diabetic patients without MaVCC (N = 2431), those with MaVCC (N = 747) had significantly lower EQ-5D index (−0.062), EQ-VAS (−9.2), SF-12 PCS (−5.0), and MCS (−2.1) after controlling for differences in sociodemographics, smoking status, diabetes severity, and comorbidities (all P < 0.001).

Conclusions

MaVCC is consistently associated with lower HRQoL for patients with diabetes in the United States. Results of this study are valuable for future comparative-effectiveness and cost-effectiveness analyses in diabetes.

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Abbreviations

AHRQ:

Agency for Healthcare Research and Quality

CCCs:

Clinical classification categories

CLAD:

Censored least absolute deviations estimator

EQ-VAS:

Euroqol visual analogue scale

HRQoL:

Health-related quality of life

HUI-3:

Health Utilities Index Mark 3

MaVCC:

Macrovascular comorbid conditions

MCS:

Mental component summary

MEPS:

Medical Expenditure Panel Survey

OLS:

Ordinary least square

PCS:

Physical component summary

QALYs:

Quality-adjusted life years

QWB-SA:

Self-Administered Quality of Well Being

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Acknowledgments

This study was supported by a research grant from Merck & Co., Inc., Whitehouse Station, New Jersey, USA.

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Authors and Affiliations

  1. Department of Quantitative Health Sciences, Cleveland Clinic, 9500 Euclid Avenue/JJN3-01, Cleveland, OH, 44195, USA

    Alex Z. Fu

  2. Global Outcomes Research, Merck & Co., Inc., Whitehouse Station, NJ, USA

    Ying Qiu & Larry Radican

  3. Department of Epidemiology and Public Health & Centre for Health Services Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Nan Luo

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  1. Alex Z. Fu
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Correspondence to Alex Z. Fu.

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Fu, A.Z., Qiu, Y., Radican, L. et al. Marginal differences in health-related quality of life of diabetic patients with and without macrovascular comorbid conditions in the United States. Qual Life Res 20, 825–832 (2011). https://doi.org/10.1007/s11136-010-9819-x

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