Author(s): Saleh F, Mumu SJ, Ara F, Hafez MA, Ali L
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Abstract BACKGROUND: Non-adherence to lifestyle modification among diabetic patients develops the short-term risks and the long-term complications as well as declines the quality of life. This study aimed to find out the association between non-adherence to self-care practices, medication and health related quality of life (HR-QoL) among type 2 diabetic patients. METHODS: At least 1 year diagnosed patients with type 2 diabetes (N = 500), age>25 years were conveniently selected from the Out-Patient Department of Bangladesh Institute of Health Sciences Hospital. Patients' self-care practices were assessed via interviewer-administered questionnaires using an analytical cross-sectional design. HRQoL was assessed by an adapted and validated Bangla version of the EQ-5D (EuroQol Group, 2009) questionnaire which has five domains- mobility, self-care, usual activities, pain/discomfort and anxiety/depression and two levels on each dimension. EQ-5D responses were further translated into single summery EQ-5D index using UK TTO value set. Patients' were considered as non-adhered to self-care practices according to the guidelines of Diabetic Association of Bangladesh. Multivariable linear regression was used to assess the association between non-adherence towards self-care practices and HRQoL. RESULTS: Among the study patients, 50.2\% were females and mean ± SD age was 54.2 (±11.2) years. Non-adherence rate were assessed for: blood glucose monitoring (37\%), diet (44.8\%), foot care (43.2\%), exercise (33.2\%) and smoking (37.2\%). About 50.4\% patients had problem in mobility, 28.2\% in self-care, 47.6\% in usual activities, 72.8\% in pain/discomfort and 73.6\% in anxiety/depression. On chi-squared test, significant association was found between non adherence to foot care and problem with mobility, self-care and usual activities (p < 0.05). Significant association was also found between non-adherence to exercise and poor mobility, self- care, usual activities, pain and anxiety (p < 0.05). Non-adherence to diet was associated with poor mobility (p < 0.05). In multivariable linear regression non-adherence to foot care (p = 0.0001), exercise (p = 0.0001), and smoking (p = 0.047) showed significant association with EQ-5D index after adjusting co-variates. CONCLUSIONS: In this study, patients who have a non-adherence rate also have a lower quality of life.
This article was published in BMC Public Health
and referenced in Journal of Diabetes & Metabolism