Quality of life among adult patients living with diabetes in Rwanda: a cross-sectional study in outpatient clinics

Objectives To report on the disease-related quality of life of patients living with diabetes mellitus in Rwanda and identify its predictors.Design Cross-sectional study, part of the baseline assessment of a cluster-randomised controlled trial.Setting Outpatient clinics for non-communicable diseases...

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Main Authors: Per Kallestrup, Charilaos Lygidakis, Claus Vögele, Jean Paul Uwizihiwe, Michela Bia, Francois Uwinkindi
Format: Article
Language:English
Published: BMJ Publishing Group 2021-02-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/2/e043997.full
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author Per Kallestrup
Charilaos Lygidakis
Claus Vögele
Jean Paul Uwizihiwe
Michela Bia
Francois Uwinkindi
author_facet Per Kallestrup
Charilaos Lygidakis
Claus Vögele
Jean Paul Uwizihiwe
Michela Bia
Francois Uwinkindi
author_sort Per Kallestrup
collection DOAJ
description Objectives To report on the disease-related quality of life of patients living with diabetes mellitus in Rwanda and identify its predictors.Design Cross-sectional study, part of the baseline assessment of a cluster-randomised controlled trial.Setting Outpatient clinics for non-communicable diseases of nine hospitals across Rwanda.Participants Between January and August 2019, 206 patients were recruited as part of the clinical trial. Eligible participants were those aged 21–80 years and with a diagnosis of diabetes mellitus for at least 6 months. Illiterate patients, those with severe hearing or visual impairments, those with severe mental health conditions, terminally ill, and those pregnant or in the postpartum period were excludedPrimary and secondary outcome measures Disease-specific quality of life was measured with the Kinyarwanda version of the Diabetes-39 (D-39) questionnaire. A glycated haemoglobin (HbA1c) test was performed on all patients. Sociodemographic and clinical data were collected, including medical history, disease-related complications and comorbidities.Results The worst affected dimensions of the D-39 were ‘anxiety and worry’ (mean=51.63, SD=25.51), ‘sexual functioning’ (mean=44.58, SD=37.02), and ‘energy and mobility’ (mean=42.71, SD=20.69). Duration of the disease and HbA1c values were not correlated with any of the D-39 dimensions. A moderating effect was identified between use of insulin and achieving a target HbA1c of 7% in the ‘diabetes control’ scale. The most frequent comorbidity was hypertension (49.0% of participants), which had a greater negative effect on the ‘diabetes control’ and ‘social burden’ scales in women. Higher education was a predictor of less impact on the ‘social burden’ and ‘energy and mobility’ scales.Conclusions Several variables were identified as predictors for the five dimensions of quality of life that were studied, providing opportunities for tailored preventive programmes. Further prospective studies are needed to determine causal relationships.Trial registration number NCT03376607.
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spelling doaj-art-2543d43557ba457c8f2191d8f1cf459c2024-11-19T02:30:11ZengBMJ Publishing GroupBMJ Open2044-60552021-02-0111210.1136/bmjopen-2020-043997Quality of life among adult patients living with diabetes in Rwanda: a cross-sectional study in outpatient clinicsPer Kallestrup0Charilaos Lygidakis1Claus Vögele2Jean Paul Uwizihiwe3Michela Bia4Francois Uwinkindi5Centre for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark1 Research Unit INSIDE (Integrative Research Unit on Social and Individual Development), Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, LuxembourgDepartment of Behavioral and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, LuxembourgSchool of Medicine and Pharmacy, Department of Primary Health Care, University of Rwanda, Kigali, Rwanda4 Labor Market, Luxembourg Institute of Socio-Economic Research, Esch-sur-Alzette, LuxembourgDivision of Non Communicable Diseases, Rwanda Biomedical Center (RBC), Kigali, RwandaObjectives To report on the disease-related quality of life of patients living with diabetes mellitus in Rwanda and identify its predictors.Design Cross-sectional study, part of the baseline assessment of a cluster-randomised controlled trial.Setting Outpatient clinics for non-communicable diseases of nine hospitals across Rwanda.Participants Between January and August 2019, 206 patients were recruited as part of the clinical trial. Eligible participants were those aged 21–80 years and with a diagnosis of diabetes mellitus for at least 6 months. Illiterate patients, those with severe hearing or visual impairments, those with severe mental health conditions, terminally ill, and those pregnant or in the postpartum period were excludedPrimary and secondary outcome measures Disease-specific quality of life was measured with the Kinyarwanda version of the Diabetes-39 (D-39) questionnaire. A glycated haemoglobin (HbA1c) test was performed on all patients. Sociodemographic and clinical data were collected, including medical history, disease-related complications and comorbidities.Results The worst affected dimensions of the D-39 were ‘anxiety and worry’ (mean=51.63, SD=25.51), ‘sexual functioning’ (mean=44.58, SD=37.02), and ‘energy and mobility’ (mean=42.71, SD=20.69). Duration of the disease and HbA1c values were not correlated with any of the D-39 dimensions. A moderating effect was identified between use of insulin and achieving a target HbA1c of 7% in the ‘diabetes control’ scale. The most frequent comorbidity was hypertension (49.0% of participants), which had a greater negative effect on the ‘diabetes control’ and ‘social burden’ scales in women. Higher education was a predictor of less impact on the ‘social burden’ and ‘energy and mobility’ scales.Conclusions Several variables were identified as predictors for the five dimensions of quality of life that were studied, providing opportunities for tailored preventive programmes. Further prospective studies are needed to determine causal relationships.Trial registration number NCT03376607.https://bmjopen.bmj.com/content/11/2/e043997.full
spellingShingle Per Kallestrup
Charilaos Lygidakis
Claus Vögele
Jean Paul Uwizihiwe
Michela Bia
Francois Uwinkindi
Quality of life among adult patients living with diabetes in Rwanda: a cross-sectional study in outpatient clinics
BMJ Open
title Quality of life among adult patients living with diabetes in Rwanda: a cross-sectional study in outpatient clinics
title_full Quality of life among adult patients living with diabetes in Rwanda: a cross-sectional study in outpatient clinics
title_fullStr Quality of life among adult patients living with diabetes in Rwanda: a cross-sectional study in outpatient clinics
title_full_unstemmed Quality of life among adult patients living with diabetes in Rwanda: a cross-sectional study in outpatient clinics
title_short Quality of life among adult patients living with diabetes in Rwanda: a cross-sectional study in outpatient clinics
title_sort quality of life among adult patients living with diabetes in rwanda a cross sectional study in outpatient clinics
url https://bmjopen.bmj.com/content/11/2/e043997.full
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