[How does intensive therapy of cardiovascular risk factors affect health-related quality of life in diabetic patients?].

Autor:	Botija Yagüe MP; Medicina Familiar y Comunitaria, Centro de Salud Barrio del Cristo, Departamento 9, Agència Valenciana de Salut, Valencia, España. pilibotija@comv.es, Lizán Tudela L, Gosalbes Soler V, Bonet Plá A, Fornos Garrigós A
Jazyk:	Spanish; Castilian
Zdroj:	Atencion primaria [Aten Primaria] 2007 May; Vol. 39 (5), pp. 227-33.
DOI:	10.1157/13101795
Abstrakt:	Objective: To assess the health-related quality of life (HRQoL) in diabetic patients who have followed a protocol of intensive treatment of cardiovascular risks (CVR). Design: Clinical trial randomised by cluster. A convenience sample of 65 primary care practitioners, randomly assigned to a control or intervention group. Patients were selected by systematic sampling from diabetic lists. The follow-up for the control group was by normal practice and the intervention group by using the intensive control of cardiovascular risk factors (CVRF) protocol. Setting: Seventeen health-centres in the Valencia Community, Spain. Participants: One hundred and eighty-four patients, 93 in the control group and 91 in the intervention group. Inclusion Criteria: patients diagnosed with diabetes mellitus (DM) type 2, aged between 45-75 years, DM for more than 2 years and less than 20 years and a cardiovascular risk (CVR) >20% after 10 years (Framingham equation). The exclusion criteria were: history of ischaemic heart disease, terminal illness, hepatic cirrhosis, renal failure, grade III-IV cardiac failure, and mental disorders. The patients self-completed the Spanish versions of the COOP/WONCA charts and a diabetes-specific tool (ADDQol questionnaire) at the start, and after 6 months and 12 months. Main Measurements: Means of COOP/WONCA charts and ADDQol. Comparison between groups using Mann-Whitney U test, and the group follow ups using the Wilcoxon test. Results: No significant differences were found in the COOP/WONCA charts. At 12 months the only significant difference was in the feelings chart (P=.024; control group 1.86+/-1.03: intervention group 2.23+/-1.11). A negative impact of diabetes was seen in all the dimensions of ADDQoL. The most negative impact of diabetes was related to diet. There were no significant differences between groups in the ADDQoL throughout the study. Conclusions: The HRQoL in diabetic patients is not affected by intensive therapy of cardiovascular risk factors. Diabetes has a negative impact on HRQoL in the patients studied.
Databáze:	MEDLINE
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