The Diabetes Health Profile - Development and applications

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The Diabetes Health Profile presented at the London Health 2012

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The Diabetes Health Profile - Development and applications

  1. 1. London Health 2012Dr Keith MeadowsDHP Research & Consultancy Ltd The Diabetes Health Profile – Developments and Practical Applications
  2. 2. Diabetes in the U.K.UK Diagnosed 2.9 million diagnosed with diabetes by 2011Diabetes type The impact 10% of 90% of people with people with diabetes have diabetes have Type 1 Type 2 52% Deaths due cardiovascular diseaseFinancial costs 21% Type 1 Deaths due to kidney disease £192 million a week Of people die within 5 years of an spent by the NHS 70% amputation Copyright DHP Research & Consultancy Ltd
  3. 3. Diabetes in the U.K. Copyright DHP Research & Consultancy Ltd
  4. 4. The psychological impact of living with diabetes The facts10% according to Diabetes UK, people with of thepopulation in diabetes are twice as likely to Britain have experience depression…depression atany one time …and the risk is higher for women than for man ANXIETY “Yet there is little aggression routine psychological Denial support for people Eating problems with diabetes.” POOR QUALITY OF LIFE Diabetes UK disruption to social life Copyright DHP Research & Consultancy Ltd
  5. 5. The Diabetes Health profile (DHP-18) The conceptual model Copyright DHP Research & Consultancy Ltd
  6. 6. The Diabetes Health profile DHP-125 In-depth patient Insulin dependent (TYPE 1) 32-items interviewsLiterature review/ Interviews with clinicians/HCP DHP-18 Insulin dependent Insulin requiring Patient /HCP Oral review Diet 18-items Psychometric testing and validation Copyright DHP Research & Consultancy Ltd
  7. 7. The Diabetes Health Profile (DHP-18) Ways of administering the DHP-18 Copyright DHP Research & Consultancy Ltd
  8. 8. For the psychometrician Copyright DHP Research & Consultancy Ltd
  9. 9. An international perspective OverUsing the DHP Type 1 and Type 2 patients have completed the DHP-18 Copyright DHP Research & Consultancy Ltd
  10. 10. Living with diabetes - Interpreting the DIABETES HEALTH PROFILE (DHP) DHP domain scores by treatment 3173 modality Mean age Disinhibeted eating 63.9 Psycholigical 55% distress91% Type 2 and 9% Type 1 45% years Insulin patients completed the Barriers to questionnaire. Oral activity Patients (mean) scores on the 40 45 50 55 60 Disinhibited eating domain Score 0=No dysfunctioning p<0.05 77% by BMI Of patients experiencing 100% three severe hypoglycaemic BMI BMI BMI 90% Barriers to activity domain episodes reported their days <25 25-34 >35 80% scores are tied to meal times. 70% 60% 59% 50% 40% Patients reporting Of patients experiencing one severe hypoglycaemic 30% severe episode reported their days 47.8 20% hypoglycaemic are tied to meal times. 10% episodes 49.2 0% 52.4 35-44 45-54 55-64 65-74 >75 Score 0=No dysfunctioning p<0.05 Score 0=No dysfunctioning Copyright DHP Research & Consultancy Ltd
  11. 11. Getting an in-depth look at diabetes with the DHP-18 Psychological Barriers to Disinhibited distress activity eating Yes Food controls life 69% MOST AT RISK MOST AT RISK MOST AT RISK Hard saying no to Yes • Comorbidity • Severe • Younger food you like 69% hypoglycaemia women • Severe hypoglycaemia • Other health • Forgetting to issues take insulin • Female • Visit to the • Unaware of • > Age psychiatrist HbA1 level Yes • Visit to the • Visit to the Eat to cheer pyschiatrist 53% psychiartrist self up Represents high scores Frequent and or Very significant Substantial and or PD substantial BA levels of anxiety DE frequent levels of Depressed Yes emotional stress restricting behaviour eating in response to due to 50% including: dysphoric and perceived food cues and diabetes mood, irritability limitations in emotional arousal. and externally social/role activities directed hostility. Copyright DHP Research & Consultancy Ltd
  12. 12. Interpreting the Diabetes Health ProfileWhat does a DHP-18 score mean?M Minimally the minimallyI Important important difference (MID) is the smallest score difference onD Difference the Diabetes Health Profile that represents the minimal clinically significant difference. The required MID change in score for the DHP-18 domains Psychological distress 7 - 11 Barriers to activity 6.5 - 9.9 Disinhibited eating 7.5 - 11.4 Copyright DHP Research & Consultancy Ltd
  13. 13. Interpreting the Diabetes Health Profile Copyright DHP Research & Consultancy Ltd
  14. 14. Thank you For more informationinfo@dhpresearch.com Copyright DHP Research & Consultancy Ltd

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