Impacto del uso de cuestionarios de calidad de vida relacionada con la salud vía internet en la práctica clínica en niños y adolescentes con diabetes mellitus tipo 1

Abstract

Type 1 diabetes mellitus (T1DM) is a chronic disease that affects all aspects of patient’s life. This study assesses the impact of systematic monitoring of health-related quality of life (HRQOL) via Internet in clinical practice in children and adolescents with T1DM. A multicenter longitudinal study was designed on 136 patients recruited from five hospitals Barcelona (72 girls, mean age 13.4 years and range 8-19 years, average HbA1c: 7.5 ± 1%). Sociodemographic and mental health variables were collected in addition to the clinical variables. HRQOL was assessed using the EuroQol-5D and KIDSCREEN indexes collected online. During the follow-up year, the patients were divided into two groups and only the intervention group discussed the results of the HRQOL with the physician at each visit (intervention group, n: 70). Complete data were collected for 119 patients (87.5%). At baseline, a descriptive study was carried out concluding that diabetic patients report similar HRQOL than the general population with worse physical well-being (score <50). HRQOL correlated with age, HbA1c and mental health; and age (coefficient B= -0.93), single-parent families (B= -15.2), adherence to treatment (B= 4.34) and mental health (B= -0.7) were the most influential factors. Over time, at the end of the study, better HRQOL scores (Effect size, ES= 0.56) were seen in the intervention group, especially in the dimensions of psychological well-being (B= 4.32) and school environment (B= 4.64); mental health (B= -0.78 [psychological well-being] and -0.43 [school environment]), family dysfunction (B= -2.99 and -3.7, respectively) and adherence to treatment (B = 3.7) were the most influential factors. There was no improvement in metabolic control. The study shows some factors to be taken into account to improve HRQOL in this population and also the feasibility of using Internet to collect this information in clinical practice.

Date of Award	24 May 2018
Original language	Spanish
Supervisor	Joan Baptista Bel Comos (Director) & Carlos Rodrigo Gonzalo de Liria (Director)