Evaluation of Health Status of Type 2 Diabetes Outpatients Receiving Care in a Tertiary Hospital in Nigeria

Abstract

ObjectivesThe aim of this study was to determine the health status of type 2 diabetes patients in a Nigerian tertiary hospital, and examine the sociodemographic and clinical variables that predicted the health status of type 2 diabetes patients in terms of utility valuations and EuroQol Visual Analogue Scale (EQ-VAS) score.MethodsThis was a cross-sectional study of 147 diabetes patients attending the University of Nigeria Teaching Hospital, Enugu State, Nigeria. The EQ-5D-5L instrument, version 2.1, was used to evaluate patients’ self-reported health status, and patients who gave informed consent completed the questionnaire while waiting to see a doctor. Descriptive and multiple linear regression analyses were performed using SPSS version 20.ResultsOverall, 147 patients participated in this study, with a mean age (± standard deviation) of 56.7 years (± 10.33). Over half of the respondents were females (55.1%) and more than half were older than 60 years of age. The mean EQ-VAS and utility valuations of respondents were 72.59 ± 10.51 and 0.72 ± 0.13, respectively. The age of respondents independently and significantly predicted EQ-VAS by −2.659 per year, while the age of respondents, level of education, duration of diabetes, and presence of other illnesses independently and significantly predicted utility valuations by −0.020 per year, +0.029 per level of education, −0.008 per year, and −0.044 per illness, respectively. Less than 39% of patients experienced no problems for each of the dimensions, except self-care (68%).ConclusionThe results of this study revealed a relatively low health status among type 2 diabetic patients in Nigeria. Old age, duration of diabetes and the presence of other illnesses were major contributors to the negative impact on health status, while a higher level of education contributed positively to health status. Adequate family support, as well as regular and effective patient counseling and education, may be worthwhile.Electronic supplementary materialThe online version of this article (doi:10.1007/s41669-017-0056-x) contains supplementary material, which is available to authorized users.

Assessment of Health-Related Quality of Life Among Patients Infected With HIV Receiving Care in a Nigerian Tertiary Hospital

“…20 Still, equal health status was independently documented in recent Nigerian studies employing the EQ-5D instrument among patients with type II diabetes. 29,33 This observation indicates that in Nigeria, HIVinfected patients value their health state similar to that of type II diabetes patients. Also, our finding was identical to the health valuations of the Zimbabwean general population (mean EQ-VAS = 79.8), whose country-specific utility weight we adopted in the present study.…”

Health-Related Quality of Life in Patients With Different Diseases Measured With the EQ-5D-5L: A Systematic Review

“…For patients with diabetes mellitus (Table 2), 12 studies reported health utility values ranging from 0.31 to 0.99 (14,15,(18)(19)(20)(21)(22)(23)(24)(25)(26)(27). The Chinese standard EQ-5D-5L value set (18) and Crosswalk UK value set (24) were used to derive the utility values in the studies that reported the highest value and lowest value, respectively.…”

“…The results showed that the utility value calculated with the Uruguay value set was the highest at 0.880, while the lowest, 0.735, was derived with the value set from the Netherlands. The EQ-5D VAS scores were reported to range from 50.9 to 72.6 in six studies (14,20,(22)(23)(24)(25). Among the five dimensions of the EQ-5D-5L, pain/discomfort was the dimension with the most reported problems.…”

Review of Ongoing Activities and Challenges to Improve the Care of Patients With Type 2 Diabetes Across Africa and the Implications for the Future

“…Typically though, the awareness of diabetes among patients remains a major challenge in SSA with only a minority of patients currently aware of their diabetic status and being actively treated, with only a small percentage being diagnosed pre-diabetes (Zekewos et al, 2018;Manne-Goehler et al, 2019). This needs to be urgently addressed given the morbidity, mortality, and costs associated with diabetes (Glover et al, 2012;Glezeva et al, 2015;Low Wang et al, 2016;Atun et al, 2017;Adibe et al, 2018;Lewis et al, 2018;Pheiffer et al, 2018;Rwegerera et al, 2018;Mapa-Tassou et al, 2019). Eighty percent of early deaths due to non-communicable diseases (NCDs) including diabetes and cardiovascular diseases (CVD) currently occur in lower and middle income countries (LMICs), with the morbidity and mortality of diabetes and other NCDs such as CVD likely to be greater than communicable disease by 2025 (Peer et al, 2014;Renzaho, 2015;Issaka et al, 2018).…”

“…In South Africa for instance as a result of changes in peoples' diet and lifestyle, diabetes has moved from being the fifth leading underlying cause of death in 2013 to now the second most common cause, representing 5.5% of all recorded deaths (Statistics South Africa, 2016;Moosa et al, 2019). T2DM also results in a lower health status and quality of life (Fasanmade and Dagogo-Jack, 2015;da Mata et al, 2016;Adibe et al, 2018;Rwegerera et al, 2018), with high rates of sight threatening retinopathy among diabetic patients in Africa (Glover et al, 2012;Jingi et al, 2015;Cairncross et al, 2017;Pastakia et al, 2017;Lewis et al, 2018) as well as nephropathy (Thomas et al, 2016;Wagnew et al, 2018) and neuropathy (Awadalla et al, 2017;Sun et al, 2020). Overall, populations of African origin appear to have the highest prevalence of microvascular complications of diabetes exacerbated by frequent high blood pressure and inappropriate diabetes control among the diabetes population along with challenges of access to appropriate care (Mbanya and Sobngwi, 2003;Mbanya et al, 2010).…”