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Change in cardio-protective medication and health-related quality of life after diagnosis of screen-detected diabetes: Results from the ADDITION-Cambridge cohort.


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Authors

Black, JA 
Long, GH 
Sharp, SJ 
Kuznetsov, L 
Boothby, CE 

Abstract

AIMS: Establishing a balance between the benefits and harms of treatment is important among individuals with screen-detected diabetes, for whom the burden of treatment might be higher than the burden of the disease. We described the association between cardio-protective medication and health-related quality of life (HRQoL) among individuals with screen-detected diabetes. METHODS: 867 participants with screen-detected diabetes underwent clinical measurements at diagnosis, one and five years. General HRQoL (EQ5D) was measured at baseline, one- and five-years, and diabetes-specific HRQoL (ADDQoL-AWI) and health status (SF-36) at one and five years. Multivariable linear regression was used to quantify the association between change in HRQoL and change in cardio-protective medication. RESULTS: The median (IQR) number of prescribed cardio-protective agents was 2 (1 to 3) at diagnosis, 3 (2 to 4) at one year and 4 (3 to 5) at five years. Change in cardio-protective medication was not associated with change in HRQoL from diagnosis to one year. From one year to five years, change in cardio-protective agents was not associated with change in the SF-36 mental health score. One additional agent was associated with an increase in the SF-36 physical health score (2.1; 95%CI 0.4, 3.8) and an increase in the EQ-5D (0.05; 95%CI 0.02, 0.08). Conversely, one additional agent was associated with a decrease in the ADDQoL-AWI (-0.32; 95%CI -0.51, -0.13), compared to no change. CONCLUSIONS: We found little evidence that increases in the number of cardio-protective medications impacted negatively on HRQoL among individuals with screen-detected diabetes over five years.

Description

Keywords

Diabetes, HRQoL, Medication, Adult, Aged, Cardiotonic Agents, Cardiovascular Diseases, Cohort Studies, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Drug Prescriptions, Female, Health Status, Humans, Male, Mass Screening, Mental Health, Middle Aged, Practice Patterns, Physicians', Quality of Life, Surveys and Questionnaires, United Kingdom

Journal Title

Diabetes Res Clin Pract

Conference Name

Journal ISSN

0168-8227
1872-8227

Volume Title

109

Publisher

Elsevier Ireland Ltd
Sponsorship
Medical Research Council (MC_UU_12015/4)
Medical Research Council (G0001164)
NETSCC (None)
Wellcome Trust (061895/Z/00/Z)
Medical Research Council (MC_U106179474)
NIHR Central Commissioning Facility (NIHRDH-RP-PG-0606-1259)
NIHR Evaluation Trials and Studies Coordinating Centre (08/116/300)
Deutsche Forschungsgemeinschaft (220677592)
ADDITION-Cambridge was supported by the Wellcome Trust (grant reference No G061895) the Medical Research Council (grant reference no: G0001164), National Health Service R&D support funding (including the Primary Care Research and Diabetes Research Networks), and the National Institute for Health Research. We received an unrestricted grant from University of Aarhus, Denmark, to support the ADDITION-Cambridge trial. Bio-Rad provided equipment to undertake capillary glucose screening by HbA1c in general practice. The Primary Care Research Unit is supported by NIHR Research funds. SJG receives support from the Department of Health NIHR Programme Grant funding scheme (RP-PG-0606-1259). This article presents independent research funded by the NIHR under the Programme Grants for Applied Research programme (RP-PG-0606-1259]. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health.