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Impact of monitoring health-related quality of life in clinical practice in children with type 1 diabetes mellitus

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Abstract

Purpose

To test whether the systematic monitoring of health-related quality of life (HRQOL) in clinical practice in Spanish pediatric patients with T1DM helps improve their daily life in a multicenter longitudinal study.

Methods

One hundred thirty-six patients participated, recruited from five centers in Barcelona, Spain (72 girls, mean age 13.4 years). Complete data were collected for 119 patients (85%). Pediatricians were randomly assigned to the HRQOL intervention (n = 70), or control group (n = 49). The intervention group discussed the results of HRQOL face to face with the physician, quarterly over a year. The control group received care as usual. HRQOL was assessed using KIDSCREEN-27 collected online. Standardized mean differences (effect size, ES) and generalized estimating equation (GEE) were computed to compare group differences between baseline and follow-up, taking into account sociodemographic and clinical variables.

Results

Statistically significant higher scores were seen in the intervention group at follow-up for the dimensions of Psychological well-being (ES = 0.56), School environment (ES = 0.56), and the KIDSCREEN-10 index (ES = 0.63). No differences were found in the control group. GEE analysis showed an improvement in HRQOL at follow-up with statistically significant association of the intervention on Psychological well-being (B = 4.32; p 0.03 for the interaction of group by follow-up) and School environment (B = 4.64; p 0.02 for the same interaction term).

Conclusions

Routine assessment and face-to-face patient-physician discussion of HRQOL results improved HRQOL scores after a year of follow-up, especially in Psychological well-being and school environment. The results support the routinary use of HRQOL assessment in clinical practice.

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Funding

The study was partially financed by the Spanish Ministry of Health, contract No. PI12/01296.

Author information

Authors and Affiliations

  1. Pediatric Service, University Hospital Germans Trias i Pujol, Ctra de Canyet s/n, Badalona, Barcelona, 08916, Spain

    Marta Murillo & Joan Bel

  2. Autonomous University of Barcelona, Barcelona, Spain

    Marta Murillo & Joan Bel

  3. Department of Pediatric Endocrine, Hospital of Sabadell, Corporació Sanitària Parc Taulí, Parc Taulí s/n, 08208, Sabadell, Spain

    Jacobo Pérez & Raquel Corripio

  4. University Institute Parc Taulí—UAB, Autonomous University of Barcelona, Campus d’Excelència Internacional, Sabadell, Spain

    Jacobo Pérez & Raquel Corripio

  5. Pediatric Endocrinology, Hospital Sant Pau, Autonomous University of Barcelona, c/Sant Quintí 89, 08026, Barcelona, Spain

    Gemma Carreras

  6. Corporació de Salut del Maresme i la Selva, Sant Jaume, 209-217, 08370, Calella, Spain

    Xavier Herrero & Josep-Maria Mengibar

  7. Catalan Agency for Health Quality and Assessment, Roc Boronat 81-95, 08005, Barcelona, Spain

    Dolors Rodriguez-Arjona

  8. Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg- Eppendorf, Martinistr. 52 (W29), 20246, Hamburg, Germany

    Ulrike Ravens-Sieberer

  9. Department of Public Health, Erasmus MC – University Medical Center Rotterdam, 3075 EA, Rotterdam, The Netherlands

    Hein Raat

  10. Health Services Research Unit, IMIM-Hospital del Mar Institute of Medical Research, Barcelona Biomedical Research Park (office 138.03), Dr Aiguader 88, 08003, Barcelona, Spain

    Luis Rajmil

Authors
  1. Marta Murillo
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  2. Joan Bel
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  7. Josep-Maria Mengibar
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  8. Dolors Rodriguez-Arjona
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  9. Ulrike Ravens-Sieberer
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  11. Luis Rajmil
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Corresponding author

Correspondence to Luis Rajmil.

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Conflict of interest

Authors declare that they have no conflicts of interest.

Ethical approval

The study was approved by the ethics committee of participant hospitals in accordance with national and international guidelines (code of ethics, Helsinki Declaration) as well as legislation on data confidentiality (Organic Law 15/1999 of December 13 Data Protection character staff).

Informed consent

Signed consent to participate was requested from all parents and also children over 12 years. The collection and transfer of data was carried out according to strict security and data encryption.

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Murillo, M., Bel, J., Pérez, J. et al. Impact of monitoring health-related quality of life in clinical practice in children with type 1 diabetes mellitus. Qual Life Res 26, 3267–3277 (2017). https://doi.org/10.1007/s11136-017-1682-6

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