Change in cardio-protective medication and health-related quality of life after diagnosis of screen-detected diabetes: Results from the ADDITION-Cambridge cohort.
OBJECTIVE
Establishing a balance between the benefits and harms of treatment is important among individuals with screen-detected diabetes, for whom the burden of treatment might be higher than the burden of the disease. We described the association between cardio-protective medication and health-related quality of life (HRQoL) among individuals with screen-detected diabetes.


METHODS
867 participants with screen-detected diabetes underwent clinical measurements at diagnosis, one and five years. General HRQoL (EQ5D) was measured at baseline, one- and five-years, and diabetes-specific HRQoL (ADDQoL-AWI) and health status (SF-36) at one and five years. Multivariable linear regression was used to quantify the association between change in HRQoL and change in cardio-protective medication.


RESULTS
The median (IQR) number of prescribed cardio-protective agents was 2 (1 to 3) at diagnosis, 3 (2 to 4) at one year and 4 (3 to 5) at five years. Change in cardio-protective medication was not associated with change in HRQoL from diagnosis to one year. From one year to five years, change in cardio-protective agents was not associated with change in the SF-36 mental health score. One additional agent was associated with an increase in the SF-36 physical health score (2.1; 95%CI 0.4, 3.8) and an increase in the EQ-5D (0.05; 95%CI 0.02, 0.08). Conversely, one additional agent was associated with a decrease in the ADDQoL-AWI (-0.32; 95%CI -0.51, -0.13), compared to no change.


CONCLUSIONS
We found little evidence that increases in the number of cardio-protective medications impacted negatively on HRQoL among individuals with screen-detected diabetes over five years.
MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Box 285, Cambridge CB2 0QQ, United Kingdom.
J A
JA
Black
MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Box 285, Cambridge CB2 0QQ, United Kingdom.
G H
GH
Long
MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Box 285, Cambridge CB2 0QQ, United Kingdom.
S J
SJ
Sharp
MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Box 285, Cambridge CB2 0QQ, United Kingdom.
L
L
Kuznetsov
MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Box 285, Cambridge CB2 0QQ, United Kingdom.
C E
CE
Boothby
MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Box 285, Cambridge CB2 0QQ, United Kingdom; Primary Care Unit, Cambridge Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge CB2 0SR, United Kingdom.
S J
SJ
Griffin
MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Box 285, Cambridge CB2 0QQ, United Kingdom. Electronic address: rks34@cam.ac.uk.
R K
RK
Simmons
D000328:Adult; D000368:Aged; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000188:drug therapy*; D003925:Diabetic Angiopathies / Q000517:prevention & control; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008403:Mass Screening; D008603:Mental Health; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011788:Quality of Life; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology
D002316:Cardiotonic Agents
Diabetes; HRQoL; Medication