THE ASSESSMENT OF PUBLIC KNOWLEDGE ON DIABETES MELLITUS AND PATIENT REPORTED OUTCOMES MEASUREMENT AMONG PATIENTS WITH TYPE DIABETES IN THAILAND TIPAPORN PONGMESA (B.Pharm (Hons.), Silpakorn University, Thailand) A THESIS SUBMITTED FOR THE DEGREE OF DOCTOR OF PHILOSOPHY DEPARTMENT OF PHARMACY NATIONAL UNIVERSITY OF SINGAPORE 2010 ACKNOWLEDGEMENTS This thesis would never have been accomplished without the involvement and support from many people I would like to take opportunity to express my deep and sincere gratitude to the following people My utmost gratitude goes to Prof Li Shu Chuen, one of my thesis supervisors, for his brilliant mentorship and supervision, as well as his kindness, understanding and continuous encouragements since the beginning of my postgraduate life Even after he left Singapore for Australia, he has always tried his best to pay attention to not only my studies but also non-studies related matters, especially my health I feel very fortunate to have him as my supervisor Likewise, I am immensely grateful to my main supervisor, Asst Prof Wee Hwee Lin, for her generosity in providing me her precious time, knowledge and invaluable advice during the past few years She has put hard efforts not only in making my studies go smoothly, but also in pushing me to be an independent thinker, careful researcher as well as a good scientific writer I wish to convey my special thanks to Ms Pranee Luckanajantachote, Ms Saifon Chaodeekornpun and their diabetes care team at Samut Sakhon Hospital in Thailand Without their excellent collaboration and active support, the studies conducted there would not have been successfully completed I am very grateful to the Royal Thai Government for the award of the Thai MOE-NUS PhD Scholarship; my employer, the Faculty of Pharmacy at Silpakorn University, for granting me a leave of absence for pursuing a PhD degree; and the Thai Ambassador to Singapore, His Excellency Nopadol Gunavibool and the staff at i the Royal Thai Embassy in Singapore for their effort and assistance in looking after the well-being of all Thai students in Singapore My sincere gratitude goes to the Department of Pharmacy at NUS for providing me an opportunity to experience postgraduate study; A/Prof Chan Sui Yung for her kindness and constant support; and my PhD thesis committees, A/Prof Paul Ho and Asst Prof Joyce Lee, for their invaluable advice and generous contribution Thanks are also due to all staffs at the department for their kind assistance in administrative issues The journey of my postgraduate study in Singapore would be tougher and boring without having lovely and helpful seniors and friends around I would like to thank my seniors, Sharon and Jin Jing, for providing me guidance and help I also cherish all my colleagues in S7 02-09, Yingjiao, Mandy, Hua Pey, Regine and Wei Ting, and my unit mates, Sureerat, Nichanan and Poonna, for their kind support and words of encouragement, as well as the wonderful and joyful moments we have spent together This thesis is dedicated to my parents and family members as well as my boyfriend for their unflagging love, consistent care and understanding Without their great encouragement and support throughout my studies, there is no doubt this thesis would not have been possible ii TABLE OF CONTENTS Acknowledgements………………………………………………………………….i Table of Contents…………………………………………………………………iii Summary………………………………………………………………………….vii List of Tables………………………………………………………………………ix List of Figures………………………………………………………………………xi List of Abbreviations………………………………………………………………xii Chapter Introduction……………………………………………………………1 1.1 The global burden of type diabetes mellitus (T2DM)………………………2 1.2 The role of disease management in containing the T2DM epidemic ………4 1.3 T2DM management in Thailand: the state of affairs………………………….5 1.4 Prevention: the cornerstone of T2DM management………………………….6 1.4.1 Knowledge of DM and its role in T2DM prevention…………………6 1.4.2 Factors associated with knowledge of DM …………………………7 1.5 Measuring the outcomes of T2DM management: the role of patient-reported outcomes (PROs)……………………………………………………………9 1.5.1 QoL as an outcome measure of T2DM management ……………… 1.5.2 Treatment satisfaction as an outcome measure of T2DM management…………………………………………………………… …12 1.5.3 Improving the external validity of PROs instruments: the role of cross-cultural adaptation………………………………………………… 14 1.6 Research objectives and thesis organization………………………………17 iii Chapter A Survey of Knowledge on Diabetes in the Central Region of Thailand………………………………………………………………………….…20 2.1 Introduction ………………………………………………………………21 2.2 Methods……………………………………………………………………23 2.3 Results……………………………………………………………………….28 2.4 Discussion…………………………………………………………………40 2.5 Conclusions…………………………………………………………………46 2.6 Acknowledgements…………………………………………………………46 Chapter A Comparison of Diabetes Knowledge among Residents in Bangkok and Other Central Provinces of Thailand……………………………………… 47 3.1 Introduction ………………………………………………………………48 3.2 Methods……………………………………………………………………50 3.3 Results………………………………………………………………………51 3.4 Discussion…………………………………………………………………57 3.5 Conclusions…………………………………………………………………61 Chapter Development of a Thai Version of the Audit of Diabetes-Dependent Quality of Life (ADDQoL-19) Questionnaire: Linguistic and Psychometric Evaluation…………………………………………………………………………62 4.1 Introduction ………………………………………………………………63 4.2 Methods……………………………………………………………………65 4.3 Results……………………………………………………………………72 4.4 Discussion…………………………………………………………………89 4.5 Conclusions…………………………………………………………………93 4.6 Acknowledgements…………………………………………………………94 iv Chapter Psychometric Evaluation of a Thai Version of the Diabetes Treatment Satisfaction Questionnaire Status Version (DTSQs)………… … 95 5.1 Introduction ………………………………………………………………96 5.2 Methods……………………………………………………………………97 5.3 Results……………………………………………………………………101 5.4 Discussion…………………………………………………………………107 5.5 Conclusions………………………………………………………………110 5.6 Acknowledgements………………………………………………………111 Chapter Health Status, Quality of Life and Treatment Satisfaction among Patients with Diabetes in Thailand………………………………………………112 6.1 Introduction ………………………………………………………………113 6.2 Methods……………………………………………………………………115 6.3 Results……………………………………………………………………118 6.4 Discussion……………………………………………………………… 129 6.5 Conclusions……………………………………………………………….132 6.6 Acknowledgements………………………………………………………132 Chapter Association between Polypharmacy and Quality of Life in Patients with Type Diabetes in Thailand………………………………………………134 7.1 Introduction……………………………………………………………….135 7.2 Methods……………………………………………………………………137 7.3 Results……………………………………………………………………139 7.4 Discussion…………………………………………………………………148 7.5 Conclusions………………………………………………………………150 7.6 Acknowledgements………………………………………………………151 v Chapter Conclusions and Recommendations for Future Studies…………152 8.1 Contributions to new knowledge…………………………………………153 8.1.1 Public knowledge of DM in Thailand……………………………153 8.1.2 The measurement of health status, QoL and treatment satisfaction among patients with DM in Thailand……………………………………154 8.1.3 Polypharmacy in patients with T2DM in Thailand………………158 8.2 Main limitations……………………………………………………………159 8.3 Recommendations for future studies………………………………………159 Bibliography …………………………………………………………………….162 vi SUMMARY The prevalence of type diabetes mellitus (T2DM) is rising at an alarming rate, making DM a major health problem worldwide A multifaceted approach is taken in the battle against T2DM, with prevention being an important cornerstone Other important components of T2DM management include DM education and measurement of patient-reported outcomes (PROs) However, currently, the impact of these approaches among Asian populations is relatively unexplored The evaluation of their impact on T2DM management is of particular importance in view of the much less abundant availability of healthcare resources in Asia Based on the afore-mentioned reasons, this thesis therefore focused on various approaches, especially health outcomes assessment, in T2DM management in Asia In our studies, Thailand was chosen as an illustrating example based on the following considerations First, T2DM is one of the most prevalent chronic diseases there, and Thailand is among the top ten countries in Asia with the highest number of adults with T2DM Second, there are limited numbers of published studies concerning this topic in the Thai population Third, Thailand is a country with a mix of rural and cosmopolitan areas which may allow further generalization of the results to other countries with similar socioeconomic compositions This thesis is broadly organized into two sections We started by evaluating DM knowledge among the general population in central Thailand and found this to be generally fair indicating the existence of a foundation for further improvement Interestingly, we found that the residents in other provinces outperformed those in the vii capital demonstrating that easier access to health information may not translate into better health knowledge Further, we identified differing factors associated with DM knowledge between the two groups highlighting the need for different emphasis in future health promotion and education This was followed by our cross-culturally adapting and validating a Thai version of the Audit of Diabetes-Dependent Quality of life (ADDQoL-19), a DMspecific QoL instrument, among DM patients in Thailand and found it to be a promising tool We also evaluated the psychometric properties of a Thai version of the Diabetes Treatment Satisfaction Questionnaire status version (DTSQs), a DMspecific treatment satisfaction instrument, and the results suggested that further improvements may be required for this instrument to be used in routine clinical setting Further, we assessed health status, quality of life (QoL) and treatment satisfaction of DM patients in Thailand We found that DM had little effect on the patients‟ perceived health status but major negative impact on their QoL while their treatment satisfaction was high We also found that the factors associated with these PROs were not identical In addition, we evaluated the association between polypharmacy and QoL and found no significant association Overall, these results would provide some insights to healthcare providers in designing more holistic intervention strategies for DM management In conclusion, our studies would at least fill a knowledge gap in DM management in Thailand (if not beyond) and would serve as a foundation for further studies in more cost-effective approach in managing DM viii LIST OF TABLES Table 2.1 Characteristics of respondents 29 Table 2.2 The respondents‟ scores in each section of the questionnaire 31 Table 2.3 The respondents‟ scores in each item 33 Table 2.4 The list of other risk factors of DM as mentioned by the respondents 36 Table 2.5 The list of other treatments for DM as mentioned by the respondents 36 Table 2.6 Evaluation of potential factors associated with knowledge on DM of the respondents ……………………………………………………………39 Table 2.7 Multiple linear regression analysis of factors assiciated with knowledge of DM .40 Table 3.1 Sociodemographic characteristics of the respondents in the Bangkok and the other central provinces groups 52 Table 3.2 Overall DM knowledge scores and scores in each section of the respondents in each group 53 Table 3.3 Factors associated with DM knowledge of the respondents in each group in univariate analyses 55 Table 3.4 Multiple linear regression analyses of factors associated with knowledge of DM (separate analyses for residents of Bangkok only, residents of other provinces only and combined sample) 56 Table 3.5 Major sources of DM information of the two groups 57 Table 4.1 Characteristics of interviewees in cognitive debriefing interviews 74 Table 4.2 Characteristics of respondents in psychometric evaluation 78 Table 4.3 Distribution of responses to the Thai ADDQoL-19 80 Table 4.4 Item rankings before and after weighting by importance………………81 Table 4.5 Standardized factor loadings from confirmatory factor analysis of the Thai ADDQoL-19 83 Table 4.6 Unforced principal components analysis with varimax rotation and forced one-factor analysis with N/A items recoded as zeros 85 Table 4.7 Reliability of the Thai ADDQoL-19 with N/A items recoded as zeros 86 ix 27 Alberti KG, Zimmet P, Shaw J International Diabetes Federation: a consensus on Type diabetes prevention Diabet Med 2007;24(5):451-63 28 Yun LS, Hassan Y, Aziz NA, Awaisu A, Ghazali R A comparison of knowledge of diabetes mellitus between patients with diabetes and healthy adults: a survey from north Malaysia Patient Educ Couns 2007;69(1-3):47-54 29 Bautista-Martinez S, Aguilar-Salinas CA, Lerman I, Velasco ML, Castellanos R, Zenteno E, et al Diabetes knowledge and its determinants in a Mexican population Diabetes Educ 1999;25(3):374-81 30 Wee HL, Ho HK, Li SC Public awareness of diabetes mellitus in Singapore Singapore Med J 2002;43(3):128-34 31 Gunay T, Ulusel B, Velipasaoglu S, Unal B, Ucku R, Ozgener N Factors affecting adult knowledge of diabetes in Narlidere Health District, Turkey Acta Diabetol 2006;43(4):142-7 32 Abdullah L, Margolis S, Townsend T Primary health care patients' knowledge about diabetes in the United Arab Emirates East Mediterr Health J 2001;7(4-5):66270 33 Caliskan D, Ozdemir O, Ocaktan E, Idil A Evaluation of awareness of diabetes mellitus and associated factors in four health center areas Patient Educ Couns 2006;62(1):142-7 34 Murata GH, Shah JH, Adam KD, Wendel CS, Bokhari SU, Solvas PA, et al Factors affecting diabetes knowledge in Type diabetic veterans Diabetologia 2003; 46(8):1170-8 35 Rafique G, Azam SI, White F Diabetes knowledge, beliefs and practices among people with diabetes attending a university hospital in Karachi, Pakistan East Mediterr Health J 2006;12(5):590-8 165 36 Soltanian AR, Bahreini F, Afkhami-Ardekani M People awareness about diabetes disease and its complications among aged 18 years and older in Bushehr port inhabitants (Iran) Diabetes & Metabolic Syndrome: Clinical Research & Reviews 2007;1(4):245-9 37 Chan YM, Molassiotis A The relationship between diabetes knowledge and compliance among Chinese with non-insulin dependent diabetes mellitus in Hong Kong J Adv Nurs 1999;30(2):431-8 38 Firestone DN, Jimenez-Briceno L, Reimann JO, Talavera GA, Polonsky WH, Edelman SV Predictors of diabetes-specific knowledge and treatment satisfaction among Costa Ricans Diabetes Educ 2004;30(2):281-92 39 He X, Wharrad HJ Diabetes knowledge and glycemic control among Chinese people with type diabetes Int Nurs Rev 2007;54(3):280-7 40 Kamel NM, Badawy YA, el-Zeiny NA, Merdan IA Sociodemographic determinants of management behaviour of diabetic patients Part II Diabetics' knowledge of the disease and their management behaviour East Mediterr Health J 1999;5(5):974-83 41 Simmons D, Meadows KA, Williams DR Knowledge of diabetes in Asians and Europeans with and without diabetes: the Coventry Diabetes Study Diabet Med 1991;8(7):651-6 42 Simmons D, Shaw L, Kenealy T, Scott D, Scragg R Ethnic differences in diabetes knowledge and education: the South Auckland Diabetes Survey N Z Med J 1994;107(978):197-200 43 Speight J, Bradley C The ADKnowl: identifying knowledge deficits in diabetes care Diabet Med 2001;18(8):626-33 166 44 Wee HL, Li SC Sociodemographic factors influencing the effectiveness of public health education - a comparison of two studies in Singapore Ann Acad Med Singapore 2007;36(11):958-61 45 Tham KY, Ong JJ, Tan DK, How KY How much diabetic patients know about diabetes mellitus and its complications? Ann Acad Med Singapore 2004;33(4): 503-9 46 Ding CH, Teng CL, Koh CN Knowledge of diabetes mellitus among diabetic and non-diabetic patients in Klinik Kesihatan Seremban Med J Malaysia 2006;61(4): 399-404 47 Murugesan N, Snehalatha C, Shobhana R, Roglic G, Ramachandran A Awareness about diabetes and its complications in the general and diabetic population in a city in southern India Diabetes Res Clin Pract 2007;77(3):433-7 48 Cramer JA, Spilker B Quality of life and pharmacoeconomics: an introduction Philadelphia: Lippincott-Raven; 1998 49 The WHOQOL Group The World Health Organization Quality of Life assessment (WHOQOL): position paper from the World Health Organization Soc Sci Med 1995;41(10):1403-9 50 Shumaker SA, Naughton MJ The international assessment of health-related quality of life: theory, translation, measurement and analysis In: Shumaker SA, Berzon RA, eds The international assessment of health-related quality of life: theory, translation, measurement, and analysis Oxford; New York: Rapid Communications; 1995 p 3-10 51 Berger ML, Bingefors K, Hedblom EC, Pashos CL, Torrance GW, Smith MD Health care cost, quality, and outcomes: ISPOR book of terms Lawrenceville (NJ): 167 International Society for Pharmacoeconomics and Outcomes Research (ISPOR); 2003 52 Doward LC, McKenna SP Defining patient-reported outcomes Value Health 2004 Sep-Oct;7 Suppl 1:S4-8 53 Moons P, Budts W, De Geest S Critique on the conceptualisation of quality of life: a review and evaluation of different conceptual approaches Int J Nurs Stud 2006; 43(7):891-901 54 Moons P Why call it health-related quality of life when you mean perceived health status? Eur J Cardiovasc Nurs 2004;3(4):275-7 55 Calvert MJ, Freemantle N Use of health-related quality of life in prescribing research Part 1: why evaluate health-related quality of life? J Clin Pharm Ther 2003; 28(6):513-21 56 Acquadro C, Berzon R, Dubois D, Leidy NK, Marquis P, Revicki D, et al Incorporating the patient's perspective into drug development and communication: an ad hoc task force report of the Patient-Reported Outcomes (PRO) Harmonization Group meeting at the Food and Drug Administration, February 16, 2001 Value Health 2003;6(5):522-31 57 Fayers PM, Machin D Quality of life: the assessment, analysis, and interpretation of patient-reported outcomes 2nd ed Chichester: John Wiley & Sons; 2007 58 Watkins K, Connell CM Measurement of health-related QOL in diabetes mellitus Pharmacoeconomics 2004;22(17):1109-26 59 Anderson RT, Aaronson NK, Wilkin D Critical review of the international assessments of health-related quality of life: generic instrument In: Shumaker SA, Berzon RA, eds The international assessment of health-related quality of life: theory, 168 translation, measurement, and analysis Oxford; New York: Rapid Communications; 1995 p 11-37 60 Staquet MJ, Hays RD, Fayers PM Quality of life assessment in clinical trials: methods and practice Oxford; New York: Oxford University Press; 1998 61 El Achhab Y, Nejjari C, Chikri M, Lyoussi B Disease-specific health-related quality of life instruments among adults diabetic: A systematic review Diabetes Res Clin Pract 2008;80(2):171-84 62 Olson SH, Iyer S, Scott J, Erez O, Samuel S, Markovits T, et al Cancer history and other personal factors affect quality of life in patients with hepatitis C Health Qual Life Outcomes 2005;3:39 63 Kelley-Gillespie N An integrated conceptual model of quality of life for older adults based on a synthesis of the literature Appl Res Qual Life 2009;4(3):259-82 64 Bradley C, Speight J Patient perceptions of diabetes and diabetes therapy: assessing quality of life Diabetes Metab Res Rev 2002;18 Suppl 3:S64-9 65 Redekop WK, Koopmanschap MA, Stolk RP, Rutten GE, Wolffenbuttel BH, Niessen LW Health-related quality of life and treatment satisfaction in Dutch patients with type diabetes Diabetes Care 2002;25(3):458-63 66 Rubin RR, Peyrot M Quality of life and diabetes Diabetes Metab Res Rev 1999;15(3):205-18 67 Gurkova E, Cap J, Ziakova K Quality of life and treatment satisfaction in the context of diabetes self-management education Int J Nurs Pract 2009;15(2):91-8 68 Wee HL, Tan CE, Goh SY, Li SC Usefulness of the Audit of Diabetes- Dependent Quality-of-Life (ADDQoL) questionnaire in patients with diabetes in a multi-ethnic Asian country Pharmacoeconomics 2006;24(7):673-82 169 69 Nicolucci A, Cucinotta D, Squatrito S, Lapolla A, Musacchio N, Leotta S, et al Clinical and socio-economic correlates of quality of life and treatment satisfaction in patients with type diabetes Nutr Metab Cardiovasc Dis 2009;19(1):45-53 70 Weaver M, Patrick DL, Markson LE, Martin D, Frederic I, Berger M Issues in the measurement of satisfaction with treatment Am J Manag Care 1997;3(4):57994 71 Shikiar R, Rentz AM Satisfaction with medication: an overview of conceptual, methodologic, and regulatory issues Value Health 2004;7(2):204-15 72 Lenderking WR Brief reflections on treatment satisfaction Value Health 2005;8 Suppl 1:S2-5 73 Revicki DA Patient assessment of treatment satisfaction: methods and practical issues Gut 2004;53 Suppl 4:iv40-4 74 Brod M, Skovlund SE, Wittrup-Jensen KU Measuring the impact of diabetes through patient report of treatment satisfaction, productivity and symptom experience Qual Life Res 2006;15(3):481-91 75 Murphy J, Coster G Issues in patient compliance Drugs 1997;54(6):797-800 76 Brod M, Christensen T, Bushnell D Maximizing the value of validation findings to better understand treatment satisfaction issues for diabetes Qual Life Res 2007;16(6):1053-63 77 Mapi Research Institute, 2001-2010 Patient-Reported Outcome and Quality of Life Instruments Database (ProQolid) http://www.proqolid.org Accessed February 23, 2010 78 Eremenco SL, Cella D, Arnold BJ A comprehensive method for the translation and cross-cultural validation of health status questionnaires Eval Health Prof 2005;28(2):212-32 170 79 Guillemin F, Bombardier C, Beaton D Cross-cultural adaptation of health- related quality of life measures: literature review and proposed guidelines J Clin Epidemiol 1993;46(12):1417-32 80 Wild D, Grove A, Martin M, Eremenco S, McElroy S, Verjee-Lorenz A, et al Principles of Good Practice for the Translation and Cultural Adaptation Process for Patient-Reported Outcomes (PRO) Measures: report of the ISPOR Task Force for Translation and Cultural Adaptation Value Health 2005;8(2):94-104 81 Leplege A, Verdier A The adaptation of health status measures: methodological aspects of the translation procedure In: Shumaker SA, Berzon RA, eds The international assessment of health-related quality of life: theory, translation, measurement and analysis Oxford; New York: Rapid Communications; 1995 p 93101 82 U.S Department of Health and Human Services FDA Center for Drug Evaluation and Research, U.S Department of Health and Human Services FDA Center for Biologics Evaluation and Research, U.S Department of Health and Human Services FDA Center for Devices and Radiological Health Guidance for industry: patient-reported outcome measures: use in medical product development to support labeling claims: draft guidance Health Qual Life Outcomes 2006;4:79 83 Beaton D, Bombardier C, Guillemin F, Ferraz MB Recommendations for the cross-cultural adaptation of health status measures Rosemont, IL: American Academy of Orthopaedic Surgeons Institute for Work & Health; revised 2002 84 Streiner DL, Norman GR Health measurement scales: a practical guide to their development and use New York: Oxford University Press; 1992 85 Hays RD, Anderson R, Revicki DA Psychometric evaluation and interpretation of health-related quality of life data In: Shumaker SA, Berzon RA, eds 171 The international assessment of health-related quality of life: theory, translation, measurement and analysis Oxford; New York: Rapid Communications; 1995 p 10314 86 Wild S, Roglic G, Green A, Sicree R, King H Global prevalence of diabetes: estimates for the year 2000 and projections for 2030 Diabetes Care 2004;27(5):104753 87 Sicree R, Shaw J Type diabetes: an epidemic or not, and why it is happening Diabetes & Metabolic Syndrome: Clinical Research & Reviews 2007;1(2):75-81 88 King H, Aubert RE, Herman WH Global burden of diabetes, 1995-2025: prevalence, numerical estimates, and projections Diabetes Care 1998;21(9):1414-31 89 Chan JC, Malik V, Jia W, Kadowaki T, Yajnik CS, Yoon KH, et al Diabetes in Asia: epidemiology, risk factors, and pathophysiology JAMA 2009;301(20):212940 90 Asia World Health Organization Prevalence of diabetes in the WHO South-East Region http://www.who.int/diabetes/facts/world_figures/en/index5.html Accessed September 23, 2009 91 Alberti G, Zimmet P, Shaw J, Bloomgarden Z, Kaufman F, Silink M Type diabetes in the young: the evolving epidemic: the international diabetes federation consensus workshop Diabetes Care 2004;27(7):1798-811 92 Forouhi N, Wareham N Epidemiology of diabetes Medicine 2006;3(2):57- 60 93 Pagano E, Brunetti M, Tediosi F, Garattini L Costs of diabetes A methodological analysis of the literature Pharmacoeconomics 1999;15(6):583-95 172 94 Pinhas-Hamiel O, Zeitler P The global spread of type diabetes mellitus in children and adolescents J Pediatr 2005;146(5):693-700 95 American Diabetes Association Standards of medical care in diabetes 2006 Diabetes Care 2006;29 Suppl 1:S4-42 96 Baker D Reading between the lines: deciphering the connections between literacy and health J Gen Intern Med 1999;14(5):315-7 97 Croxson S Diabetes in the elderly: problems of care and service provision Diabet Med 2002;19 Suppl 4:66-72 98 Owens G Gender differences in health care expenditures, resource utilization, and quality of care J Manag Care Pharm 2008;14(3):S2-6 99 Sussangkarn C, Jitsuchon S The sub-prime crisis and Thailand‟s growth rebalancing TDRI Quarterly Review 2009;24(2):3-9 100 American Diabetes Association Gestational diabetes mellitus Diabetes Care 2003;26 Suppl 1:S103-5 101 National Statistical Office, Ministry of Information and Communication Technology, Thailand Reading survey, Thailand 2008 http://service.nso.go.th/nso/nsopublish/themes/themes_2-3-1.html Accessed January 30, 2009 102 Brown GC, Brown MM, Sharma S, Brown H, Gozum M, Denton P Quality of life associated with diabetes mellitus in an adult population J Diabetes Complications 2000;14(1):18-24 103 Maddigan SL, Feeny DH, Johnson JA Health-related quality of life deficits associated with diabetes and comorbidities in a Canadian National Population Health Survey Qual Life Res 2005;14(5):1311-20 173 104 Speight J, Reaney MD, Barnard KD Not all roads lead to Rome-a review of quality of life measurement in adults with diabetes Diabet Med 2009;26(4):315-27 105 Field AP Discovering statistics using SPSS: (and sex, drugs and rock 'n' roll) 3rd ed London: SAGE; 2009 106 Bradley C, Todd C, Gorton T, Symonds E, Martin A, Plowright R The development of an individualized questionnaire measure of perceived impact of diabetes on quality of life: the ADDQoL Qual Life Res 1999;8(1-2):79-91 107 The EuroQoL Group EuroQol a new facility for the measurement of health- related quality of life Health Policy 1990;16(3):199-208 108 Greiner W, Weijnen T, Nieuwenhuizen M, Oppe S, Badia X, Busschbach J, et al A single European currency for EQ-5D health states Results from a six-country study Eur J Health Econ 2003;4(3):222-31 109 Coffey JT, Brandle M, Zhou H, Marriott D, Burke R, Tabaei BP, et al Valuing health-related quality of life in diabetes Diabetes Care 2002;25(12):2238-43 110 Davis RE, Morrissey M, Peters JR, Wittrup-Jensen K, Kennedy-Martin T, Currie CJ Impact of hypoglycaemia on quality of life and productivity in type and type diabetes Curr Med Res Opin 2005;21(9):1477-83 111 Hirsch A, Bartholomae C, Volmer T Dimensions of quality of life in people with non-insulin-dependent diabetes Qual Life Res 2000;9(2):207-18 112 Kamarul Imran M, Ismail AA, Naing L, Wan Mohamad WB The reliability and validity of the Malay version of the 18-item audit of Diabetes Dependent Quality of Life (the Malay ADDQOL) questionnaire Southeast Asian J Trop Med Public Health 2007;38(2):398-405 174 113 Costa F, Guerreiro J, Duggan C An Audit of Diabetes Dependent Quality of Life (ADDQoL) for Portugal: exploring validity and reliability Pharmacy Practice 2006;4(3):123-8 114 Gupta GR, Weiss E Women's lives and sex: implications for AIDS prevention Cult Med Psychiatry 1993;17(4):399-12 115 Tomarken AJ, Waller NG Structural equation modeling: strengths, limitations, and misconceptions Annu Rev Clin Psychol 2005;1:31-65 116 Bradley C, Lewis KS Measures of psychological well-being and treatment satisfaction developed from the responses of people with tablet-treated diabetes Diabet Med 1990;7(5):445-51 117 Gerber RA, Cappelleri JC, Kourides IA, Gelfand RA Treatment satisfaction with inhaled insulin in patients with type diabetes: a randomized controlled trial Diabetes Care 2001;24(9):1556-9 118 Anderson RT, Skovlund SE, Marrero D, Levine DW, Meadows K, Brod M, et al Development and validation of the insulin treatment satisfaction questionnaire Clin Ther 2004;26(4):565-78 119 Bradley C Diabetes Treatment Satisfaction Questionnaire (DTSQ) In: Bradley C, ed Handbook of psychology and diabetes: a guide to psychological measurement in diabetes research and management Chur, Switzerland; Langhorne, Pa., U.S.A.: Harwood Academic Publishers; 1994 p 111-32 120 Bradley C, Plowright R, Stewart J, Valentine J, Witthaus E The Diabetes Treatment Satisfaction Questionnaire change version (DTSQc) evaluated in insulin glargine trials shows greater responsiveness to improvements than the original DTSQ Health Qual Life Outcomes 2007;5:57 175 121 Ozmen B, Eser E, Ozkaya Kafesciler S, Pala T, Guclu F, Hekimsoy Z Psychometric properties and responsiveness of the Turkish version of the Diabetes Treatment Satisfaction Questionnaire (s) on a sample of diabetics of three consecutive monitoring periods Acta Diabetol 2009 Nov 20 [Epub ahead of print] 122 Westaway Questionnaire: a MS, Seager cross-cultural JR South The Diabetes African Treatment perspective Satisfaction Diabetes Care 2004;27(2):618 123 Cortina JM What is coefficient alpha? An examination of theory and applications J Appl Psychol 1993;78(1):98-104 124 Biderman A, Noff E, Harris SB, Friedman N, Levy A Treatment satisfaction of diabetic patients: what are the contributing factors? Fam Pract 2009;26(2):102-8 125 Amiel SA, Dixon T, Mann R, Jameson K Hypoglycaemia in Type diabetes Diabet Med 2008;25(3):245-54 126 Lundkvist J, Berne C, Bolinder B, Jonsson L The economic and quality of life impact of hypoglycemia Eur J Health Econ 2005;6(3):197-202 127 Levy AR, Christensen TL, Johnson JA Utility values for symptomatic non- severe hypoglycaemia elicited from persons with and without diabetes in Canada and the United Kingdom Health Qual Life Outcomes 2008;6:73 128 Nicolucci A, Giorgino R, Cucinotta D, Zoppini G, Muggeo M, Squatrito S, et al Validation of the Italian version of the WHO-Well-Being Questionnaire (WHOWBQ) and the WHO-Diabetes Treatment Satisfaction Questionnaire (WHO-DTSQ) Diabetes Nutr Metab 2004;17(4):235-43 129 Chaveepojnkamjorn W, Pichainarong N, Schelp FP, Mahaweerawat U Quality of life and compliance among type diabetic patients Southeast Asian J Trop Med Public Health 2008;39(2):328-34 176 130 Sakthong P, Charoenvisuthiwongs R, Shabunthom R A comparison of EQ-5D index scores using the UK, US, and Japan preference weights in a Thai sample with type diabetes Health Qual Life Outcomes 2008;6:71 131 WHO Expert Consultation Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies Lancet 2004;363(9403):157-63 132 Kind P, Hardman G, Macran S UK population norms for EQ-5D: York Centre for Health Economics, Discussion paper, University of York; 1999 133 Sundaram M, Kavookjian J, Patrick JH, Miller LA, Madhavan SS, Scott VG Quality of life, health status and clinical outcomes in Type diabetes patients Qual Life Res 2007;16(2):165-77 134 Sung S, Goh S, Bee Y, Poon J, Li S, Thumboo J Reliability and validity of the Chinese version of the Audit of Diabetes-dependent Quality of Life (C-ADDQoL) questionnaire among Singaporeans with diabetes mellitus Appl Health Econ Health Policy (accepted) 135 Grant RW, Devita NG, Singer DE, Meigs JB Polypharmacy and medication adherence in patients with type diabetes Diabetes Care 2003;26(5):1408-12 136 Austin RP Polypharmacy as a risk factor in the treatment of type diabetes Diabetes Spectr 2006;19:13-5 137 Gerstein HC, Miller ME, Byington RP, Goff DC, Jr., Bigger JT, Buse JB, et al Effects of intensive glucose lowering in type diabetes N Engl J Med 2008; 358(24):2545-59 138 Patel A, MacMahon S, Chalmers J, Neal B, Billot L, Woodward M, et al Intensive blood glucose control and vascular outcomes in patients with type diabetes N Engl J Med 2008;358(24):2560-72 177 139 Holman RR, Paul SK, Bethel MA, Matthews DR, Neil HA 10-year follow-up of intensive glucose control in type diabetes N Engl J Med 2008;359(15):1577-89 140 Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type diabetes (UKPDS 33) UK Prospective Diabetes Study (UKPDS) Group Lancet 1998; 352(9131):837-53 141 Gorard DA Escalating polypharmacy QJM 2006;99(11):797-800 142 Fulton MM, Allen ER Polypharmacy in the elderly: a literature review J Am Acad Nurse Pract 2005;17(4):123-32 143 Wyles H, Rehman HU Inappropriate polypharmacy in the elderly Eur J Intern Med 2005;16(5):311-3 144 Ibrahim IA, Kang E, Dansky KH Polypharmacy and possible drug-drug interactions among diabetic patients receiving home health care services Home Health Care Serv Q 2005;24(1-2):87-99 145 Pirmohamed M, James S, Meakin S, Green C, Scott AK, Walley TJ, et al Adverse drug reactions as cause of admission to hospital: prospective analysis of 18820 patients BMJ 2004;329(7456):15-9 146 Linjakumpu T, Hartikainen S, Klaukka T, Veijola J, Kivela SL, Isoaho R Use of medications and polypharmacy are increasing among the elderly J Clin Epidemiol 2002;55(8):809-17 147 Delamater AM Improving patient adherence Clin Diabetes 2006;24(2):71-7 148 Huang ES, Brown SE, Ewigman BG, Foley EC, Meltzer DO Patient perceptions of quality of life with diabetes-related complications and treatments Diabetes Care 2007;30(10):2478-83 178 149 Wexler DJ, Grant RW, Wittenberg E, Bosch JL, Cagliero E, Delahanty L, et al Correlates of health-related quality of life in type diabetes Diabetologia 2006;49(7): 1489-97 150 Vegda K, Nie JX, Wang L, Tracy CS, Moineddin R, Upshur RE Trends in health services utilization, medication use, and health conditions among older adults: a 2-year retrospective chart review in a primary care practice BMC Health Serv Res 2009;9:217 151 Payne J, Neutel I, Cho R, DesMeules M Factors Associated with Women's Medication Use BMC Womens Health 2004;4 Suppl 1:S29 152 Obermeyer CM, Schulein M, Hardon A, Sievert LL, Price K, Santiago AC, et al Gender and medication use: an exploratory, multi-site study Women Health 2004; 39(4):57-73 153 American Diabetes Association Standards of medical care in diabetes 2008 Diabetes Care 2008;31 Suppl 1:S12-54 154 Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC report JAMA 2003; 289(19):2560-72 179 ... perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns.”(49) In PRO research, the. .. associated with knowledge of DM  compare the level of DM knowledge among the residents in Bangkok (the capital and the largest city in Thailand) and that of the residents in other central provinces The. .. 33 32 30 30 28 27 24 21 20 18 17 20 12 10 10 10 -2 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 overall score According to the grading criteria established, 26 .9%, 58.8% and