Therapeutics and Clinical Risk Management (Dec 2021)
Emotional Distress is Associated with Lower Health-Related Quality of Life Among Patients with Diabetes Using Antihypertensive and/or Antihyperlipidemic Medications: A Multicenter Study in Indonesia
Abstract
Sofa D Alfian,1,2 Nurul Annisa,1,3 Aulia Iskandarsyah,4 Dyah A Perwitasari,5 Petra Denig,6 Eelko Hak,7 Rizky Abdulah1,2 1Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia; 2Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Jatinangor, Indonesia; 3Unit of Clinical Pharmacy and Community, Faculty of Pharmacy, Universitas Mulawarman, Samarinda, Indonesia; 4Department of Clinical Psychology, Faculty of Psychology, Universitas Padjadjaran, Jatinangor, Indonesia; 5Department of Clinical Pharmacy, Faculty of Pharmacy, Universitas Ahmad Dahlan, Yogyakarta, Indonesia; 6Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands; 7Unit of Pharmaco-Therapy, Epidemiology & Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The NetherlandsCorrespondence: Sofa D AlfianDepartment of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jl. Raya Jatinangor, KM 21, Jatinangor, Sumedang, IndonesiaTel/Fax +62 22-7796200Email [email protected]: To evaluate the associations between different types of diabetes distress and health-related quality of life (HRQOL) among patients with type 2 diabetes (T2DM) using antihypertensive and/or antihyperlipidemic medications in Indonesia and to explore the differences between those using only antihypertensive, only antihyperlipidemic, or both medications.Methods: A multicenter cross-sectional study was conducted in Community Health Centers in three cities in Indonesia among patients with T2DM aged at least 18 years who were using antihypertensive and/or antihyperlipidemic medications. Diabetes distress subscales (emotional, regimen-related, interpersonal, and physician-related distress) and HRQOL were assessed using a validated diabetes distress scale-17 and EQ-5D-5L scale, respectively. Multiple linear regression models were used to evaluate the associations between different types of diabetes distress and HRQOL adjusting for confounders.Results: Most of the 503 participants were females (67.6%) and aged 60– 69 years (40.8%). Emotional distress was negatively associated with HRQOL among the whole group of patients (β: − 0.08; 95% confidence interval (CI): − 0.10, − 0.05; p < 0.001). This association was similar across all therapeutic subgroups. Regimen-related distress (β: − 0.06; 95% CI: − 0.09, − 0.03; p < 0.001) and interpersonal distress (β: − 0.02; 95% CI: − 0.05, − 0.01; p = 0.022) were negatively associated, whereas physician-related distress (β: 0.04; 95% CI: 0.01, 0.07; p = 0.037) was positively associated with HRQOL among the whole group. These associations were also observed among those using only antihypertensive medication.Conclusion: Emotional distress affects HRQOL in T2DM patients treated for cardiovascular comorbidities, independent of antihypertensive and/or antihyperlipidemic medication use.Keywords: diabetes distress, quality of life, lipid-lowering medication, blood pressure-lowering medication
