Abstract

MENDES, Zilda et al. Disease self monitoring and quality of life of diabetic patients: Observational study in community pharmacies. Rev. Port. Sau. Pub. [online]. 2016, vol.34, n.1, pp.11-19. ISSN 0870-9025.  https://doi.org/10.1016/j.rpsp.2015.06.007.

Aim To describe co-morbidities and complications of the disease in patients with diabetes, and to characterize the frequency of self monitoring of the disease. To measure quality of life of these patients and identify possible factors associated to quality of life. Methods An observational study was carried out inviting 800 community pharmacies, with national coverage, to participate. Patients with at least one prescription, for personal use, of the therapeutic subgroup A10 of the ATC/DDD Classification of WHO were invited to answer two questionnaires. The factors potentially associated with quality of life were identified using logistic regression with propensity scores. Results A total of 211 pharmacies participated in the study (26.4%). Of the 1,479 patients recruited, 53.7% were female and had on average 64.1 years old. Neuropathy (27.3%), retinopathy (22.4%) and nephropathy (11.9%) were the more frequently reported complications associated with the disease. The majority referred doing auto-vigilance of the blood glucose values at least once or twice a month. About 28%, referred that had never or rarely done foot self monitoring and 27% had never visited an ophthalmologist. About 25% of all participants reported annual vigilance of blood glucose values and HbA1c. Blood glucose lowering drugs (excluding insulin) were used by more than 80% of the patients. The ADDQoL questionnaire was answered by 1,151 participants. The average score revealed a negative impact of the disease. Variables identified as more associated to this negative impact were: nephropathy (OR = 2.2 (95% confidence interval {95%CI}: 1.28-3.86)), insulin use (OR = 2.2 (95%CI: 1.35-3.50)), age (OR = 1.9 (95%CI:1.21-3.05)), retinopathy (OR = 1.8 (95%CI: 1.12-2.91)) and physical exercise (OR = 0.5 (95%CI: 0.33-0.83)). Conclusions The study results contributed for a better knowledge of co-morbidities, complications and self monitoring of the disease in diabetic patients. It was found that this disease has a negative effect in the quality of life of the patients, with significant more impact in the elderly patients and in insulin users, and lower impact in patients doing physical exercise. In this study, the propensity score model using nephropathy and retinopathy variables as potential confounders showed better predictive power.

Keywords : Diabetes; Observational studies; Quality of life; Propensity scores.

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