Assessing health-related quality of life of people with diabetes in Nigeria using the EQ-5D-5L: a cross-sectional study (original) (raw)

Abstract

Assessing the health-related quality of life (HRQoL) of people with diabetes is important to evaluate treatment effectiveness and identify interventions that would be beneficial to the patients. This descriptive cross-sectional study aimed to assess the HRQoL of people with diabetes visiting 15 community pharmacies in Akwa Ibom State, Nigeria, and to identify its determinants. The English (Nigeria) version of the EQ-5D-5L was administered to 420 eligible patients between August and September 2021. Data were analyzed with SPSS (IBM version 25.0) and presented descriptively; differences in HRQoL scores were examined using inferential statistics. Statistical significance was set at p < 0.05. Most participants (56.8%) were female; 193 (49.6%) were between the ages of 30 and 49. The median (interquartile range, IQR) for the EQ VAS and EQ-5D-5L index scores, respectively, were 80.0 (65.0-85.0) and 0.77 (0.62-0.90). Most participants reported problems with usual activities (52.7%), pain/discomfort (60.2%), and anxiety/depression (57.6%). The EQ VAS score and EQ-5D-5L utility index were significantly (p < 0.05) associated with respondents' age, marital status, work status, and personal monthly income. The HRQoL of participants was relatively high. Nevertheless, implementing strategies aimed at pain management and providing psychological support for people with diabetes in Nigeria may improve their HRQoL. Diabetes is one of the fastest growing global health emergencies of the twenty-first century 1. According to the International Diabetes Federation 1 , there were about 537 million people with diabetes globally in 2021; this figure is projected to rise to 643 million by 2030 and to 783 million by 2045, indicating a 46% global increase in prevalence. In Africa, about 24 million adults were living with the disease in 2021. This figure is projected to rise to about 55 million by the year 2045, suggesting a 134% increase, making Africa the region with the world's fastest growing diabetes rate 1. A meta-analysis by Uloko et al. reported a diabetes prevalence of 5.77% in Nigeria 2. This suggests that 11.2 million Nigerians were living with the disease in 2017 based on the country's 193.3 million population as of September 2017 3. The south-south geopolitical zone of the country had the highest diabetes prevalence, 9.8%, according to the meta-analysis 2. Diabetes poses a serious global threat to the health and well-being of individuals affected, their families and nations at large 1. People living with diabetes are at risk of developing a range of debilitating and life-threatening complications, leading to a reduced (health-related) quality of life and premature death 1. Hays and Reeve define health-related quality of life (HRQoL) as how well an individual functions in their daily life as well as their perceived well-being in physical, mental and social health domains 4. In contrast to the functional component of HRQoL which consists of behaviours that can be observed by others, the well-being component refers to internal, subjective perceptions like vitality, pain, anxiety, depressive symptoms, and general health perceptions 4. HRQoL is an important patient-reported outcome which is increasingly being used to evaluate the effect of a medical intervention on a symptom or function or a group of symptoms or functions 5. It is a relevant input to conduct health economic evaluations and identify cost-effective interventions that lead to efficient allocation of scarce resources 6. Assessment of HRQoL can foster patient engagement with care and enhance a patient-centered approach to treatment 5. This is because findings from HRQoL studies can identify subgroups with relatively poor perceived HRQoL and help to guide interventions to enhance their situations and avert more serious consequences 7. Instruments used to measure HRQoL may be specific or generic. Specific instruments focus on

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