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Masyuko S, Ngongo CJ, Smith C, Nugent R. Patient-reported outcomes for diabetes and hypertension care in low- and middle-income countries: A scoping review. PLoS One 2021; 16:e0245269. [PMID: 33449968 PMCID: PMC7810280 DOI: 10.1371/journal.pone.0245269] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 12/26/2020] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Patient-reported outcome measures (PROMs) assess patients' perspectives on their health status, providing opportunities to improve the quality of care. While PROMs are increasingly used in high-income settings, limited data are available on PROMs use for diabetes and hypertension in low-and middle-income countries (LMICs). This scoping review aimed to determine how PROMs are employed for diabetes and hypertension care in LMICs. METHODS We searched PubMed, EMBASE, and ClinicalTrials.gov for English-language studies published between August 2009 and August 2019 that measured at least one PROM related to diabetes or hypertension in LMICs. Full texts of included studies were examined to assess study characteristics, target population, outcome focus, PROMs used, and methods for data collection and reporting. RESULTS Sixty-eight studies met the inclusion criteria and reported on PROMs for people diagnosed with hypertension and/or diabetes and receiving care in health facilities. Thirty-nine (57%) reported on upper-middle-income countries, 19 (28%) reported on lower-middle-income countries, 4 (6%) reported on low-income countries, and 6 (9%) were multi-country. Most focused on diabetes (60/68, 88%), while 4 studies focused on hypertension and 4 focused on diabetes/hypertension comorbidity. Outcomes of interest varied; most common were glycemic or blood pressure control (38), health literacy and treatment adherence (27), and acute complications (22). Collectively the studies deployed 55 unique tools to measure patient outcomes. Most common were the Morisky Medication Adherence Scale (7) and EuroQoL-5D-3L (7). CONCLUSION PROMs are deployed in LMICs around the world, with greatest reported use in LMICs with an upper-middle-income classification. Diabetes PROMs were more widely deployed in LMICs than hypertension PROMs, suggesting an opportunity to adapt PROMs for hypertension. Future research focusing on standardization and simplification could improve future comparability and adaptability across LMIC contexts. Incorporation into national health information systems would best establish PROMs as a means to reveal the effectiveness of person-centered diabetes and hypertension care.
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Affiliation(s)
- Sarah Masyuko
- RTI International, Seattle, Washington, United States of America
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
- Ministry of Health, Nairobi, Kenya
| | - Carrie J. Ngongo
- RTI International, Seattle, Washington, United States of America
- * E-mail:
| | - Carole Smith
- RTI International, Seattle, Washington, United States of America
- Department of Neurology, University of Washington, Seattle, Washington, United States of America
| | - Rachel Nugent
- RTI International, Seattle, Washington, United States of America
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The effectiveness of traditional Chinese medicine-based lifestyle interventions on biomedical, psychosocial, and behavioral outcomes in individuals with type 2 diabetes: A systematic review with meta-analysis. Int J Nurs Stud 2018; 80:165-180. [DOI: 10.1016/j.ijnurstu.2018.01.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 01/13/2018] [Accepted: 01/16/2018] [Indexed: 11/23/2022]
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Gao L, Ji L, Su Q, Feng B, Shan Z, Hu R, Xing X, Xue Y. Impact of structured self-monitoring of blood glucose on the quality of life of insulin-treated Chinese patients with type 2 diabetes mellitus: Results from the COMPASS study. Diabetes Res Clin Pract 2016; 112:88-93. [PMID: 26774907 DOI: 10.1016/j.diabres.2015.08.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 06/13/2015] [Accepted: 08/07/2015] [Indexed: 11/22/2022]
Abstract
AIMS To evaluate the effect of structured self-monitoring of blood glucose (SMBG) regimen on quality of life (QoL) in poorly controlled insulin-treated patients with type 2 diabetes. METHODS Phase II of the COMPASS trial was a 6-month, multicenter, prospective, single-arm, interventional study. This study recruited 820 outpatients from 19 clinical sites in China who met the following inclusion criteria: type 2 diabetes, insulin treatment for ≥ 3 months, and age 18-65 years, an HbA1c >8.0% (64 mmol/mol), and willingness to perform SMBG. Subjects were advised to follow a structured SMBG regimen specific to their insulin regimen, and were trained to respond to SMBG readings via lifestyle changes and insulin dose self-adjustment. QoL assessments (SF-36) were performed at baseline and 6 months. RESULTS Patients with a mean age of 55.13 ± 9.77 years had an average diabetes duration of 9.83 ± 7.05 years and had been receiving insulin therapy for a mean of 45.4 ± 46.79 months. All QoL parameters were significantly improved following structured SMBG after 6 months, most notably the physical role functioning (p<0.0001) and emotional role functioning (p<0.0001) component scores. Overall, 40.6% of patients rated their overall QoL as 'a bit' or a lot better' after structured SMBG compared with 16.5% prior to the intervention (p<0.0001). SMBG also improved overall feelings of wellbeing, with 39.13% of patients believing that their health was deteriorating prior to SMBG compared with only 14.4% of patients after the intervention (p<0.0001). CONCLUSIONS The structured SMBG program in insulin-treated Chinese outpatients with type 2 diabetes significantly improved QoL outcomes. Physical and emotional role functioning are the 2 QoL scales that demonstrate the largest improvement with SMBG.
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Affiliation(s)
- L Gao
- Peking University People's Hospital, Beijing, China
| | - L Ji
- Peking University People's Hospital, Beijing, China.
| | - Q Su
- Xin Hua Hospital, Shanghai, China
| | - B Feng
- Tongji University Oriental Hospital, Shanghai, China
| | - Z Shan
- The First Hospital of China Medical University, Liaoning, China
| | - R Hu
- Huashan Hospital, Shanghai, China
| | - X Xing
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Y Xue
- Nan Fang Hospital, Guangdong, China
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Wang HF, Yu NC, Sheu WHH, Yeh MC. The development of a questionnaire measure of diabetes-related distress in Chinese-speaking patients: the Diabetes-Related Distress Questionnaire (DRDQ). Qual Life Res 2015; 25:721-9. [PMID: 26296258 DOI: 10.1007/s11136-015-1106-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE To develop and evaluate the reliability and validity of a Diabetes-Related Distress Questionnaire for Chinese-speaking patients with diabetes. METHODS The Diabetes-Related Distress Questionnaire (DRDQ) included 11 quality-of-life questions translated from a Diabetes, Attitudes, Wishes, and Needs study and four native items developed by researchers based on patients' experiences. A sample of 981 Chinese-speaking patients with diabetes in Taiwan was invited to complete the questionnaire. RESULTS A minimum of 4.2 % of patients used each response option for each item. Exploratory factor analysis suggested a two-factor structure, representing treatment-related distress (factor 1) and progression-related distress (factor 2). The mean loading of items on their corresponding factor was high (0.60), while the mean loading on the other factor was low (0.10). A confirmatory factor analysis confirmed a single structure of the DRDQ (root-mean-square error of approximation = 0.063, comparative fit index = 0.93). The Cronbach's alpha was 0.89 for the DRDQ scale, 0.87 for the factor 1, and 0.68 for the factor 2. As expected, people with insulin-treated and HbA1c > 7 % reported significantly greater negative scores than their counterparts on the total score and all items of the DRDQ, with the exception of item 2. A moderate effect size was demonstrated between insulin known groups (ranging from 0.14 to 0.46) and between HbA1c known groups (ranging from 0.08 to 0.87). CONCLUSIONS The DRDQ is a psychometrically sound instrument that can be used to assess diabetes-related distress in Chinese-speaking patients in Taiwan.
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Affiliation(s)
- Huey-Fen Wang
- Department of Nursing, Yuanpei University of Medical Technology, Hsinchu, Taiwan
| | | | - Wayne H-H Sheu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan.,College of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Mei Chang Yeh
- School of Nursing, College of Medicine, National Taiwan University, No 1, Sec 1, Jen-Ai Rd, Taipei, 10051, Taiwan.
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Hu F, Niu L, Chen R, Ma Y, Qin X, Hu Z. The association between social capital and quality of life among type 2 diabetes patients in Anhui province, China: a cross-sectional study. BMC Public Health 2015; 15:786. [PMID: 26276271 PMCID: PMC4542125 DOI: 10.1186/s12889-015-2138-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 08/11/2015] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND To investigate the association between social capital and quality of life among type 2 diabetes patients in Anhui province, China. METHODS In a cross-sectional study, 436 adults with type 2 diabetes were interviewed. The two domains of Quality of life, physical component summary (PCS) and mental component summary (MCS), were measured using the Short-Form Health Survey (SF-36). A modified instrument scale was used to measure cognitive and structural social capital. Multiple logistic regression models were used to assess the associations between social capital and quality of life, adjusting for social economic status and risk factors for health. RESULTS 24.3 % of participants (106) were in poor PCS and 25.0 % (109) in poor MCS. The proportions of participants who had low cognitive and structural social capital were 47.0 % (205) and 64.4 % (281), respectively. Results of logistic regression models showed that cognitive social capital was positively associated with PCS (OR = 1.84; 95 % CI: 1.12, 3.02) and MCS (OR = 1.65; 95 % CI: 1.03, 2.66). However, the associations between structural social capital and PCS (OR = 0.80, 95 % CI: 0.48, 1.34) and MCS (OR = 0.62; 95 % CI: 0.38, 1.01) were not statistically significant. CONCLUSIONS It is the first study in China to investigate associations between quality of life and social capital in type 2 diabetes. Findings document that cognitive social capital is associated with the quality of life of type 2 diabetes patients. Our study suggests that the social capital theory may provide a new approach to increase physical resources in diabetes prevention and control, especially in Low and Middle Income countries (LMICs).
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Affiliation(s)
- Fuyong Hu
- Hefei Second People's Hospital, Hefei, China. .,School of Health Services Management, Anhui Medical University, No. 81, Meishan Road, Hefei, 230032, Anhui, China.
| | - Li Niu
- The First Affiliated Hospital of Anhui Medical University, Hefei, China.
| | - Ren Chen
- School of Health Services Management, Anhui Medical University, No. 81, Meishan Road, Hefei, 230032, Anhui, China.
| | - Ying Ma
- School of Health Services Management, Anhui Medical University, No. 81, Meishan Road, Hefei, 230032, Anhui, China.
| | - Xia Qin
- School of Health Services Management, Anhui Medical University, No. 81, Meishan Road, Hefei, 230032, Anhui, China.
| | - Zhi Hu
- School of Health Services Management, Anhui Medical University, No. 81, Meishan Road, Hefei, 230032, Anhui, China.
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Machinani S, Bazargan-Hejazi S, Hsia SH. Psychological insulin resistance among low-income, U.S. racial minority patients with type 2 diabetes. Prim Care Diabetes 2013; 7:51-55. [PMID: 23254254 PMCID: PMC3593744 DOI: 10.1016/j.pcd.2012.11.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Revised: 11/13/2012] [Accepted: 11/18/2012] [Indexed: 12/14/2022]
Abstract
AIMS To examine psychological insulin resistance (PIR), the unwillingness to accept insulin therapy, within a unique U.S. population of patients with diabetes. METHODS A cross-sectional survey of PIR among low-income, U.S. Latino and African-American (AA) patients with type 2 diabetes recruited from a diabetes specialty clinic. RESULTS Data from 136 insulin-naïve respondents (57% female, 69% Latino, mean age 51.1 ± 10.3 years; $200-$1000 median monthly household income; grade 8-12 median education) revealed a 48% prevalence of complete unwillingness to begin insulin. In comparing Latinos to AA, Latino respondents were younger, lived fewer years in the U.S., had less education, were more likely unwilling to use insulin (53% vs. 30%, p = 0.03), and reported a more negative attitude to 8 of 9 PIR domains (p ≤ 0.01 for each). Fewer years in the U.S. predicted greater unwillingness and a more negative attitude on 8 of 9 PIR domains (p ≤ 0.03 for each); and less education predicted greater feelings of unfairness (p = 0.01). CONCLUSIONS PIR is highly prevalent among low income, U.S. Latino patients with type 2 diabetes. Our data may help to better guide culturally appropriate counseling regarding insulin use.
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Affiliation(s)
- Suman Machinani
- Division of Endocrinology, Metabolism & Molecular Medicine, Department of Internal Medicine; Charles R. Drew University of Medicine and Science, 1731 East 120 Street, Los Angeles, California, USA, 90059
| | - Shahrzad Bazargan-Hejazi
- Division of Endocrinology, Metabolism & Molecular Medicine, Department of Psychiatry; Charles R. Drew University of Medicine and Science, 1731 East 120 Street, Los Angeles, California, USA, 90059
| | - Stanley H. Hsia
- Division of Endocrinology, Metabolism & Molecular Medicine, Department of Internal Medicine; Charles R. Drew University of Medicine and Science, 1731 East 120 Street, Los Angeles, California, USA, 90059
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Kong L, Cai Y, Mei G, Gu R, Zhang X, Qin Y, Cai Y, Li Y, Zhou H, Zhang M, Yang T. Psychological status and diabetes-related distress of Chinese type 1 diabetes patients in Jiangsu province, China. J Biomed Res 2013; 27:380-5. [PMID: 24086171 PMCID: PMC3783823 DOI: 10.7555/jbr.27.20120112] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Revised: 11/06/2012] [Accepted: 11/16/2012] [Indexed: 11/09/2022] Open
Abstract
We sought to assess the psychological status and diabetes-related distress of Chinese type 1 diabetes patients in Jiangsu province, China. According to the World Health Organization criteria, 42 patients with type 1 diabetes were enrolled in the study and assessed with the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS) and Diabetes Distress Scale (DDS). All data were tabulated and statistical analyses were performed. The study summarized cases of 42 patients with type 1 diabetes, including 17 males and 25 females with a mean age of 23±12 years and a mean duration of diabetes of 7±6 years. Compared to the Chinese normative data, the SAS standard score was significantly higher, whereas SDS standard score had no statistical significance. The SAS standard score was most highly correlated with diabetes duration (γ = 0.547, P = 0.011). Additionally, 19.5% of the patients had moderate or even severe diabetes-related distress and 21.4% had moderate or even severe emotional burden while 26.2% had regimen-related distress. Multiple stepwise regression analysis showed that the mean correlation between DDS and the four domains was high, particularly the emotional burden domain (estimated β = 0.363, P < 0.001) and regimen-related distress domain (estimated β = 0.356, P < 0.001). The correlation between SAS and DDS was positive (estimated β = 0.039, P = 0.027). In conclusion, the results showed the importance of psychological aspects in Chinese individuals with type 1 diabetes. Screening and treatment of psychological aspects may result in better adherence and increased quality of life for patients with diabetes.
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Affiliation(s)
- Lulu Kong
- Department of Endocrinology, the First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China
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