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The impact of diabetic retinopathy and diabetic macular edema on health-related quality of life in type 1 and type 2 diabetes.

Abstract To assess the impact of diabetic retinopathy (DR) and diabetic macular edema (DME) on health-related quality of life (HRQoL) in type 1 and type 2 diabetes using the EuroQoL EQ-5D generic multi-attribute utility instrument (MAUI).
PMID
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Authors

Mayor MeshTerms

Health Status

Quality of Life

Keywords
Journal Title investigative ophthalmology & visual science
Publication Year Start




PMID- 22205611
OWN - NLM
STAT- MEDLINE
DA  - 20120214
DCOM- 20120403
LR  - 20151119
IS  - 1552-5783 (Electronic)
IS  - 0146-0404 (Linking)
VI  - 53
IP  - 2
DP  - 2012 Feb 13
TI  - The impact of diabetic retinopathy and diabetic macular edema on health-related
      quality of life in type 1 and type 2 diabetes.
PG  - 677-84
LID - 10.1167/iovs.11-8992 [doi]
AB  - PURPOSE: To assess the impact of diabetic retinopathy (DR) and diabetic macular
      edema (DME) on health-related quality of life (HRQoL) in type 1 and type 2
      diabetes using the EuroQoL EQ-5D generic multi-attribute utility instrument
      (MAUI). METHODS: In this cross-sectional study, 577 patients with diabetes were
      recruited from specialized eye clinics in Melbourne, Australia. Each patient
      underwent clinical, biochemical, and anthropometric assessments. The severity of 
      combined DR and DME (no DR/DME; mild NPDR [nonproliferative DR (NPDR)] and/or
      mild DME; moderate NPDR and/or moderate DME; and vision-threatening DR (VTDR)
      (severe NPDR or PDR and/or severe DME) in the worse eye was calculated. EQ-5D
      utility measures were the main outcome. Because the distribution of the utility
      measures was skewed, independent associations were explored using multivariate
      quantile regression models (five quintiles, namely 15th, 30th, 45th, 60th, 75th) 
      ranging from poorest to highest HRQoL. RESULTS: Median age of the participants
      was 66 years (range, 26-90 years). Of the 577 participants, 223 (38.7%) had no
      DR/DME, 35 (6.1%) had mild NPDR/DME, 127 (22.0%) had moderate NPDR/DME, and 192
      (33.3%) had VTDR. In adjusted models, neither presence nor severity of DR/DME was
      significantly associated with any quantile of the EQ-5D. In contrast, the
      presence of diabetic complications (other than DR) (beta = -0.153; SE = 0.052; P 
      < 0.001), other nonocular comorbidities (beta = -0.115; SE = 0.038; P < 0.01),
      and higher body mass index (beta = -0.007; SE = 0.002; P < 0.001) were all
      associated with worse HRQoL. CONCLUSIONS: Using a generic MAUI, the EQ-5D, the
      authors found that the presence or severity of DR/DME and concomitant vision loss
      were not associated with any quantile of HRQoL. These findings suggest that the
      EQ-5D lacks sensitivity in assessing the impact of the severity of DR/DME on
      HRQoL parameters and that condition-specific instruments may better capture the
      full impact of the association.
FAU - Fenwick, Eva K
AU  - Fenwick EK
AD  - Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye
      and Ear Hospital, Melbourne, Australia.
FAU - Xie, Jing
AU  - Xie J
FAU - Ratcliffe, Julie
AU  - Ratcliffe J
FAU - Pesudovs, Konrad
AU  - Pesudovs K
FAU - Finger, Robert P
AU  - Finger RP
FAU - Wong, Tien Y
AU  - Wong TY
FAU - Lamoureux, Ecosse L
AU  - Lamoureux EL
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120213
PL  - United States
TA  - Invest Ophthalmol Vis Sci
JT  - Investigative ophthalmology & visual science
JID - 7703701
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Blindness/complications/epidemiology/*psychology
MH  - Cross-Sectional Studies
MH  - Diabetes Mellitus, Type 1/complications/psychology
MH  - Diabetes Mellitus, Type 2/complications/psychology
MH  - Diabetic Retinopathy/complications/epidemiology/*psychology
MH  - Female
MH  - *Health Status
MH  - Humans
MH  - Macular Edema/complications/epidemiology/*psychology
MH  - Male
MH  - Middle Aged
MH  - *Quality of Life
MH  - Risk Factors
MH  - Surveys and Questionnaires/*standards
MH  - Victoria/epidemiology
EDAT- 2011/12/30 06:00
MHDA- 2012/04/04 06:00
CRDT- 2011/12/30 06:00
AID - iovs.11-8992 [pii]
AID - 10.1167/iovs.11-8992 [doi]
PST - epublish
SO  - Invest Ophthalmol Vis Sci. 2012 Feb 13;53(2):677-84. doi: 10.1167/iovs.11-8992.