The importance of factors determining the low health-related quality of life in people presenting with a diabetic foot ulcer – the Eurodiale study.

TY - JOUR

T1 - The importance of factors determining the low health-related quality of life in people presenting with a diabetic foot ulcer – the Eurodiale study.

AU - Siersma, Volkert Dirk

AU - Thorsen, H

AU - Holstein, PE

AU - Kars, M

AU - Apelqvist, J

AU - Jude, EB

AU - Piagessi, A

AU - Bakker, K

AU - Edmonds, M

AU - Jirkovska, A

AU - Mauricio, D

AU - Tennvall, GR

AU - Reike, H

AU - Spraul, M

AU - Uccioli, L

AU - Urbancic, V

AU - Acker, K

AU - Baal, J

AU - Schaper, NC

PY - 2013/11

Y1 - 2013/11

N2 - Aim: To identify the factors responsible for the low health-related quality of life associated with foot ulcers and the relative importance of these factors. Methods: A total of 1232 patients with a new foot ulcer, who presented at one of the 14 centres in 10 European countries participating in the Eurodiale study, were included in this cross-sectional study. Patient and ulcer characteristics were obtained as well as results from the Euro-Qol-5D questionnaire, a health-related quality of life instrument with five domains (mobility, self-care, usual activities, pain/discomfort and anxiety/depression). To analyse the relative importance of comorbidities and ulcer- and patient-related factors for health-related quality of life, linear regression models were used to calculate the relative contributions of each factor to the fit (R2) of the model. Results: Patients reported poor overall health-related quality of life, with problems primarily in the mobility and pain/discomfort domains. Among the comorbidities, the inability to stand or walk without help was the most important determinant of decreased health-related quality of life in all five domains. Among ulcer-related factors, ulcer size, limb-threatening ischaemia and elevated C-reactive protein concentration also had high importance in all domains. The clinical diagnosis of infection, peripheral arterial disease and polyneuropathy were only important in the pain/discomfort domain. Conclusions: The factors that determine health-related quality of life are diverse and to an extent not disease-specific. To improve health-related quality of life, treatment should not only be focused on ulcer healing but a multifactorial approach by a specialized multidisciplinary team is also important.

AB - Aim: To identify the factors responsible for the low health-related quality of life associated with foot ulcers and the relative importance of these factors. Methods: A total of 1232 patients with a new foot ulcer, who presented at one of the 14 centres in 10 European countries participating in the Eurodiale study, were included in this cross-sectional study. Patient and ulcer characteristics were obtained as well as results from the Euro-Qol-5D questionnaire, a health-related quality of life instrument with five domains (mobility, self-care, usual activities, pain/discomfort and anxiety/depression). To analyse the relative importance of comorbidities and ulcer- and patient-related factors for health-related quality of life, linear regression models were used to calculate the relative contributions of each factor to the fit (R2) of the model. Results: Patients reported poor overall health-related quality of life, with problems primarily in the mobility and pain/discomfort domains. Among the comorbidities, the inability to stand or walk without help was the most important determinant of decreased health-related quality of life in all five domains. Among ulcer-related factors, ulcer size, limb-threatening ischaemia and elevated C-reactive protein concentration also had high importance in all domains. The clinical diagnosis of infection, peripheral arterial disease and polyneuropathy were only important in the pain/discomfort domain. Conclusions: The factors that determine health-related quality of life are diverse and to an extent not disease-specific. To improve health-related quality of life, treatment should not only be focused on ulcer healing but a multifactorial approach by a specialized multidisciplinary team is also important.

U2 - 10.1111/dme.12254

DO - 10.1111/dme.12254

M3 - Journal article

SN - 0742-3071

VL - 30

SP - 1382

EP - 1387

JO - Diabetic Medicine

JF - Diabetic Medicine

IS - 11

ER -