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. 2014 Nov 26;9(11):e113802.
doi: 10.1371/journal.pone.0113802. eCollection 2014.

Associations between disease awareness and health-related quality of life in a multi-ethnic Asian population

Kavita Venkataraman  1 , ChinMeng Khoo  2 , Hwee Lin Wee  3 , Chuen Seng Tan  1 , Stefan Ma  4 , Derrick Heng  4 , Jeannette Lee  1 , E Shyong Tai  2 , Julian Thumboo  5
Affiliations

Associations between disease awareness and health-related quality of life in a multi-ethnic Asian population

Kavita Venkataraman et al. PLoS One. .

Abstract

Background: Health related quality of life (HRQoL) is an important dimension of individuals' well-being, and especially in chronic diseases like diabetes and hypertension. The objective of this study was to evaluate the contributions of disease process, comorbidities, medication or awareness of the disease to HRQoL in diabetes mellitus, hypertension and dyslipidemia.

Methods: This was a cross-sectional study of 3514 respondents from the general community in Singapore, assessed for HRQoL, disease and comorbid conditions through self-report, clinical and laboratory investigations. HRQoL was assessed using SF-36 health survey version 2. For each condition, participants were categorized as having 1) no disease, 2) undiagnosed, 3) diagnosed, not taking medication, and 4) diagnosed, taking medication. Analysis used one-way ANOVA and multiple linear regression.

Results: Diagnosed disease was associated with lower physical health component summary (PCS) scores across all three conditions. After adjustment for comorbidities, this association remained significant only for those not on medication in diabetes (-2.7±1.2 points, p = 0.03) and dyslipidemia (-1.3±0.4 points, p = 0.003). Diagnosed hypertension (no medication -2.6±0.9 points, p = 0.002; medication -1.4±0.5 points, p = 0.004) and dyslipidemia (no medication -0.9±0.4 points, p = 0.03; medication -1.9±0.5 points, p<0.001) were associated with lower mental health component summary (MCS) scores. Undiagnosed disease was associated with higher MCS in diabetes (2.4±1.0 points, p = 0.01) and dyslipidemia (0.8±0.4 points, p = 0.045), and PCS in hypertension (1.2±0.4 points, p = 0.004).

Conclusions: Disease awareness was associated with lower HRQoL across the diseases studied, with PCS associations partially mediated by comorbidities. Equally importantly, undiagnosed disease was not associated with HRQoL deficits, which may partly explain why these individuals do not seek medical care.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Inclusion of participants in the study.
Figure 2
Figure 2. Metabolic derangement across disease awareness categories.
a) Diabetes mellitus. b) Hypertension. c) Dyslipidemia. Reference category: Individuals with undiagnosed disease in each disease. *** - p<0.001.
See this image and copyright information in PMC

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