Quality of Life Assessment in Diabetic Patients Using a Validated Tool in a Patient Population Visiting a Tertiary Care Center in Bhubaneswar, Odisha, India.

ABSTRACT

Odisha has 4.2 million diabetic patients against the country's 70 million with an urban prevalence of nearly 15.4%. Diabetes is affecting younger age groups, thus having a crucial impact on quality of life of the affected. A qualitative endeavour was attempted at the diabetic clinic of a tertiary care set up in the capital city of Bhubaneswar to create a diabetic surveillance data assembly, wherein subjects above 18 years of age and newly diagnosed or on follow-up, after obtaining informed consent, were made to respond to a quality of life (QOLID) validated tool. The pretested tool has 8-domain role limitation due to physical health, physical endurance, general health, treatment satisfaction, symptom botherness, financial worries, emotional/mental health, and diet advice tolerance. The validated tool had 34 items (questions) that were selected to represent these domains on the basis of extraction communality, factor loading, and interitem and item-total correlations. The final questionnaire had an overall Cronbach's alpha value of 0.894 (subscale 0.55 to 0.85), showing high internal consistency in the current study population. A score for each domain was calculated by simple addition of items scores. Each individual domain score was then standardized by dividing by maximum possible domain score and multiplying by 100. All individual standardized domain scores were then added and divided by 8 (number of domain) to obtain an overall score. The data collection was done for 400 patients as an interim analysis. Univariate and subsequently multivariate analysis was performed to decide the predictors that affected quality of life. Age over 50 years (OR = 1.81, CI 1.12-2.93; p=0.014), female gender (OR = 2.05, CI 1.26-3.35; p=0.004), having foot complications (OR = 2.81, CI 1.73-4.55; p < 0.001), and having depression (OR = 1.88, CI 1.15-3.06, p=0.011) emerged as predictors of poor QOLID scores. The tool can be made a subtle part of chronic case management of diabetes to ensure patient's participation in the treatment of the disease and to create a database that can redefine diabetic care in India to suit the diverse regional settings in the country.