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

• Published in: Therapeutics and clinical risk management 2021-01, Vol.17, p.1333-1342
• Main Authors: Alfian, Sofa D, Annisa, Nurul, Iskandarsyah, Aulia, Perwitasari, Dyah A, Denig, Petra, Hak, Eelko, Abdulah, Rizky
• Format: Article
• Language: English
• Subjects: Analysis; Anticholesteremic agents; Antihypertensive drugs; Antihypertensives; blood pressure-lowering medication; Community health services; Diabetes; diabetes distress; Diabetics; Education; Health insurance; Hypertension; Industrialized nations; lipid-lowering medication; Mental depression; Mental health; Original Research; Patients; Pharmacists; Quality of life; Questionnaires; Regression analysis; Sociodemographics; Type 2 diabetes
• ISSN: 1176-6336; 1178-203X; 1178-203X
• DOI: 10.2147/TCRM.S329694

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. 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. 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. Emotional distress affects HRQOL in T2DM patients treated for cardiovascular comorbidities, independent of antihypertensive and/or antihyperlipidemic medication use.