title: Impact of primary care-based disease management on the health-related quality of life in patients with type 2 diabetes and comorbidity.
abstract: OBJECTIVE
  This study examined the effectiveness of the German diabetes disease management program (DMP) for patients with varying numbers of other medical conditions with respect to their health-related quality of life (HRQoL).
  
  
  METHODS
  A questionnaire, including the HRQoL-measured EQ-5D, was mailed to a random sample of 3,546 patients with type 2 diabetes (59.3% female). The EQ-5D score was analyzed by grouping patients according to those on a DMP and those receiving routine care.
  
  
  RESULTS
  The analysis showed that participation in the DMP (P < 0.001), the number of other medical conditions (P < 0.001), and the interaction between the DMP and the number of other conditions (P < 0.05) had a significant impact on the EQ-5D score.
  
  
  CONCLUSIONS
  Our findings suggest that the number of other medical conditions may have a negative impact on the HRQoL of patients with type 2 diabetes. The results demonstrate that the German DMP for type 2 diabetes may help counterbalance this effect.
authors.affiliation: Department of General Practice and Health Services Research, University Hospital of Heidelberg, Heidelberg, Germany. dominik.ose@med.uni-heidelberg
authors.forename: Dominik
authors.initials: D
authors.lastname: Ose
authors.forename: Michel
authors.initials: M
authors.lastname: Wensing
authors.forename: Joachim
authors.initials: J
authors.lastname: Szecsenyi
authors.forename: Stefanie
authors.initials: S
authors.lastname: Joos
authors.forename: Katja
authors.initials: K
authors.lastname: Hermann
authors.forename: Antje
authors.initials: A
authors.lastname: Miksch
mesh_terms: D000368:Aged; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D019468:Disease Management; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D011788:Quality of Life; D011795:Surveys and Questionnaires