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. 2021 May 18;64(5):575-583.
doi: 10.20945/2359-3997000000223.

Health-related quality of life associated with diabetic retinopathy in patients at a public primary care service in southern Brazil

Ângela Jornada Ben  1 , Camila Furtado de Souza  2 , Franciele Locatelli  3 , Ana Paula Oliveira Rosses  4 , Adriana Szortika  5 , Aline Lutz de Araujo  6 , Gabriela de Carvalho  3 , Daniel Lavinsky  3 , Jeruza Lavanholi Neyeloff  7 , Cristina Rolim Neumann  8
Affiliations

Health-related quality of life associated with diabetic retinopathy in patients at a public primary care service in southern Brazil

Ângela Jornada Ben et al. Arch Endocrinol Metab. .

Abstract

Objective: This study aimed to establish the utility values of different health states associated with diabetic retinopathy in a Brazilian sample to provide input to model-based economic evaluations.

Methods: This cross-sectional study was performed in a sample of patients with type 2 diabetes mellitus (T2D) who underwent teleophthalmology screening at a primary care service from 2014 to 2016. Five diabetic retinopathy health states were defined: absent, non-sight-threatening, sight-threatening, and bilateral blindness. Utility values were estimated using the Brazilian EuroQol five dimensions (EQ-5D) tariffs. Descriptive statistics were calculated. Analysis of covariance was performed to adjust the utility values for potential confounders.

Results: The study included 206 patients. The mean (± standard deviation [SD]) utility value was 0.765 ± 0.19 (95% confidence interval [CI], 0.740-0.790). The adjusted mean utility value was 0.748 (95% CI, 0.698-0.798) in patients without diabetic retinopathy, 0.752 (95% CI, 0.679-0.825) in those with non-sight-threatening state, 0.628 (95% CI, 0.521-0.736) in those with sight-threatening state, and 0.355 (95% CI, 0.105-0.606) in those with bilateral blindness. A significant utility decrement was found between patients without diabetic retinopathy and those with a sight-threatening health state (0.748 vs. 0.628, respectively, p = 0.04).

Conclusion: The findings suggest that a later diabetic retinopathy health state is associated with a decrement in utility value compared with the absence of retinopathy in patients with T2D. The results may be useful as preliminary input to model-based economic evaluations. Further research is needed to investigate the impact of diabetic retinopathy on health-related quality of life in a sample more representative of the Brazilian population.

Keywords: EQ-5D; diabetic retinopathy; health-related quality of life; utility values.

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Conflict of interest statement

Disclosure: no potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1. Plots showing mean utility values by diabetic retinopathy (DR) health states stratified by sex, other comorbidities, ophthalmic diseases, and macrovascular and microvascular complications. A statistically significant interaction was observed between other comorbidities and DR health states.
NoDR: absence of diabetic retinopathy; Non-STDR: non-sight-threatening diabetic retinopathy; STDR: sight-threatening diabetic retinopathy; BB: bilateral blindness.
Appendix 2
Appendix 2. Percentage of reported problems by dimension of the EuroQol five dimensions (EQ-5D) according to diabetic retinopathy (DR) health states.
NoDR: absence of diabetic retinopathy; Non-STDR: non-sight-threatening diabetic retinopathy; STDR: sight-threatening diabetic retinopathy; BB: bilateral blindness; Disc: Discomfort. Anx/Depr: Anxiety/Depression.
See this image and copyright information in PMC

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