Diabetes Health Profile

Last updated

The Diabetes Health Profile (DHP) is a diabetes-specific patient reported outcome measure (PROM) developed to evaluate the health-related quality of life (HRQoL) of people living with Type 1 and Type 2 diabetes aged 16 years and older. It has been used in community surveys, research studies, clinical trials, and educational interventions both in Europe and completed globally by more than 10,000 patients. The DHP was the diabetes-specific PROM selected by the UK Department of Health for their Long Terms Conditions PROM Pilot Study being carried out by Oxford University. [1]

Contents

Diabetes Health Profile (DHP-1)

Based on a conceptual model the DHP-1 [2] was developed for people with Type 1 diabetes to assess the impact of living with diabetes has on patients quality of life1. Developed using a multimethod methodology including, in-depth interviews with patients, clinical consensus and extensive psychometric validation, the DHP-1 comprises 32 items which are summed to provide three domain scores measuring: Psychological distress – (14-items) (dysphoric mood, feelings of hopelessness, irritability, self-harm, feeling of external hostility); Barriers to activity (13-items) (perceived limitation to activity, operant anxiety) and Disinhibited eating (5-items) (lack of eating control, response to food cues and emotional arousal). The observed Flesch Kincaid readability statistic is 5.8 for the DHP-1 and a Flesch reading ease is 74.7. Completion time is approximately 9–12 minutes. The DHP-1 has demonstrates highly satisfactory measurement properties including reliability coefficients > 0.80, construct, convergent and criterion validity and ability to discriminate between patients experiencing hypoglycaemic episodes. [3] [4] [5]

Diabetes Health Profile (DHP-18, DHP-3D & DHP-5D)

The DHP-18 was developed for people with Type 1 and Type 2 diabetes to measure the impact of living with diabetes on the patient's quality of life(5). It comprises 18 items which capture the three key domains based on a conceptual model and conceptual framework identified for the DHP-1. These are, Psychological distress – 6-items (dysphoric mood, feelings of hopelessness, irritability); Barriers to activity 7-items ( perceived limitation to activity, operant anxiety) and Disinhibited eating 5-items (lack of eating control, response to food cues and emotional arousal). The observed Flesch Kincaid readability statistic is 4.5 for the DHP-1 and a Flesch reading ease is 83.0. Completion time is approximately 5–6 minutes.

The DHP-18 has demonstrated very good measurement properties including reliability coefficient >0.70 and the ability to discriminate between different treatment and patient groups. [3] [6]

Both the DHP-3D and DHP-5D can be used to provide condition-specific utility values to complement generic utilities from more widely validated measures such as the EuroQol-5 Dimension.

Scoring the DHP

Items are scored using a 4-point Likert-type scale ranging from 0-3. Domain raw scores are transformed to a common score range of 0-100, with 0 representing no dysfunction.

Uses

Language versions

The DHP has been officially adapted for use in 32 languages including:

Bulgarian, Canada (English), Canada (French), Croatian, Czech, Danish, Finnish, Flemish, French, French (Swiss), German, German (Austrian), German (Swiss), Hungarian, Italian, Italian (Swiss), Mandarin, Netherlands, Norwegian, Polish, Romanian, Slovak, Slovenian, Spanish, Swedish, US (English), US (Spanish), Turkish (for Germany), Waloon

Licensing

Clinical Outcomes – an activity within Oxford University Innovation ltd, the technology transfer company of the University of Oxford, manage the licensing and marketing of the Diabetes Health Profile (DHP)

Related Research Articles

<span class="mw-page-title-main">Quality-adjusted life year</span> Measure of disease burden

The quality-adjusted life year (QALY) is a generic measure of disease burden, including both the quality and the quantity of life lived. It is used in economic evaluation to assess the value of medical interventions. One QALY equates to one year in perfect health. QALY scores range from 1 to 0 (dead). QALYs can be used to inform health insurance coverage determinations, treatment decisions, to evaluate programs, and to set priorities for future programs.

<span class="mw-page-title-main">Disability-adjusted life year</span> Measure of disease burden

The disability-adjusted life year (DALY) is a measure of overall disease burden, expressed as the number of years lost due to ill-health, disability or early death. It was developed in the 1990s as a way of comparing the overall health and life expectancy of different countries.

A patient-reported outcome (PRO) is a health outcome directly reported by the patient who experienced it. It stands in contrast to an outcome reported by someone else, such as a physician-reported outcome, a nurse-reported outcome, and so on. PRO methods, such as questionnaires, are used in clinical trials or other clinical settings, to help better understand a treatment's efficacy or effectiveness. The use of digitized PROs, or electronic patient-reported outcomes (ePROs), is on the rise in today's health research setting.

<span class="mw-page-title-main">Quality of life (healthcare)</span> Notion in healthcare

In general, quality of life is the perceived quality of an individual's daily life, that is, an assessment of their well-being or lack thereof. This includes all emotional, social and physical aspects of the individual's life. In health care, health-related quality of life (HRQoL) is an assessment of how the individual's well-being may be affected over time by a disease, disability or disorder.

Linguistic validation is the process of investigating the reliability, conceptual equivalence, and content validity of translations of patient-reported outcome (PRO) measures.

The Patient Health Questionnaire (PHQ) is a multiple-choice self-report inventory that is used as a screening and diagnostic tool for mental health disorders of depression, anxiety, alcohol, eating, and somatoform disorders. It is the self-report version of the Primary Care Evaluation of Mental Disorders (PRIME-MD), a diagnostic tool developed in the mid-1990s by Pfizer Inc. The length of the original assessment limited its feasibility; consequently, a shorter version, consisting of 11 multi-part questions - the Patient Health Questionnaire was developed and validated.

The Patient Activation Measure (PAM) is a commercial product which assesses an individual's knowledge, skill, and confidence for managing one's health and healthcare. Individuals who measure high on this assessment typically understand the importance of taking a pro-active role in managing their health and have the skills and confidence to do so.

The Patient-Reported Outcomes Measurement Information System (PROMIS) provides clinicians and researchers access to reliable, valid, and flexible measures of health status that assess physical, mental, and social well–being from the patient perspective. PROMIS measures are standardized, allowing for assessment of many patient-reported outcome domains—including pain, fatigue, emotional distress, physical functioning and social role participation—based on common metrics that allow for comparisons across domains, across chronic diseases, and with the general population. Further, PROMIS tools allow for computer adaptive testing, efficiently achieving precise measurement of health status domains with few items. There are PROMIS measures for both adults and children. PROMIS was established in 2004 with funding from the National Institutes of Health (NIH) as one of the initiatives of the NIH Roadmap for Medical Research.

The Migraine Specific Quality of Life (MSQoL) is a patient-reported outcome measure which assesses the quality of life of migraineurs. It is a 25-item questionnaire which is filled out by the patient and is used to determine how the patient's life has been affected by their migraines.

The Rheumatoid Arthritis Quality of Life Questionnaire (RAQoL) is a disease-specific patient-reported outcome measure which determines the effect rheumatoid arthritis has on a patient’s quality of life. The RAQoL has 30 items with a yes and no response format and takes about six minutes to complete.

The Psoriatic Arthritis Quality of Life (PsAQoL) measure is a disease specific patient-reported outcome measure which measures the effect that psoriatic arthritis has on a patient’s quality of life.

The Nottingham Health Profile (NHP) is a general patient reported outcome measure which seeks to measure subjective health status.

The Quality of Well-Being Scale (QWB) is a general health quality of life questionnaire which measures overall status and well-being over the previous three days in four areas: physical activities, social activities, mobility, and symptom/problem complexes.

Gary Roy Geffken is an American clinical psychologist from Gainesville, Florida. As director of the University of Florida Obsessive Compulsive Disorder Program, Geffken participates in clinical activity and research. Geffken's primary research interests include Obsessive Compulsive Disorder and Type 1 Diabetes.

The Somatic Symptom Scale - 8 (SSS-8) is a brief self-report questionnaire used to assess somatic symptom burden. It measures the perceived burden of common somatic symptoms. These symptoms were originally chosen to reflect common symptoms in primary care but they are relevant for a large number of diseases and mental disorders. The SSS-8 is a brief version of the popular Patient Health Questionnaire - 15 (PHQ-15).

EQ-5D is a standardised measure of health-related quality of life developed by the EuroQol Group to provide a simple, generic questionnaire for use in clinical and economic appraisal and population health surveys. EQ-5D assesses health status in terms of five dimensions of health and is considered a ‘generic’ questionnaire because these dimensions are not specific to any one patient group or health condition. EQ-5D can also be referred to as a patient-reported outcome (PRO) measure, because patients can complete the questionnaire themselves to provide information about their current health status and how this changes over time. ‘EQ-5D’ is not an abbreviation and is the correct term to use when referring to the instrument in general.

The Dermatology life Quality Index (DLQI) is a ten-question questionnaire used to measure the impact of skin disease on the quality of life of an affected person. It is designed for people aged 16 years and above.

The nine-item Patient Health Questionnaire (PHQ-9) is a depressive symptom scale and diagnostic tool introduced in 2001 to screen adult patients in primary care settings. The instrument assesses for the presence and severity of depressive symptoms and a possible depressive disorder. The PHQ-9 is a component of the larger self-administered Patient Health Questionnaire (PHQ), but can be used as a stand-alone instrument. The PHQ is part of Pfizer's larger suite of trademarked products, called the Primary Care Evaluation of Mental Disorders (PRIME-MD). The PHQ-9 takes less than three minutes to complete. It is scored by simply adding up the individual items' scores. Each of the nine items reflects a DSM-5 symptom of depression. Primary care providers can use the PHQ-9 to screen for possible depression in patients.

CORE-OM is a common self-report measure of global distress. It can be used as an initial screening tool and as an assessment tool of the response to psychological therapy.

References

  1. PROMs Pilot Study, Department of Public Health, University of Oxford. University of Oxford for Nuffield Department of Population Health. Retrieved 26 November 2014.
  2. K. Meadows, N. Steen, E. McColl, M. Eccles, C. Shiels, J. Hewison, A. Hutchinson (April 1996). The Diabetes Health Profile (DHP): a new instrument for assessing the psychosocial profile of insulin requiring patients - development and psychometric evaluation. Quality of Life ResearchVol 5 Issue 2. Springer International. Retrieved 26 November 2014.
  3. 1 2 Health related quality of life reference values (DHP) in people with diabetes living in France - Entred study, 2001-2003.. cab direct. Retrieved 26 November 2014.
  4. Factors associated with health-related quality of life in people with type 2 diabetes living in France. HBLO Retrieved 26 November 2014.
  5. "Diabetes AI". Wednesday, 2 December 2020
  6. Hippisley-Cox, J; Yates, J; Pringle, M; Coupland, C; Hammersley, V (2006). "Sex inequalities in access to care for patients with diabetes in primary care: questionnaire survey". Br J Gen Pract. 56 (526): 342–8. PMC   1837842 . PMID   16638249.

Further reading