PMID- 30454062 OWN - NLM STAT- MEDLINE DCOM- 20190129 LR - 20240403 IS - 1477-7525 (Electronic) IS - 1477-7525 (Linking) VI - 16 IP - 1 DP - 2018 Nov 19 TI - Patient reported barriers are associated with low physical and mental well-being in patients with co-morbid diabetes and chronic kidney disease. PG - 215 LID - 10.1186/s12955-018-1044-2 [doi] LID - 215 AB - BACKGROUND: Little is known about how patient reported barriers to health care impact the quality of life (HRQoL) of patients with comorbid disease. We investigated patient reported barriers to health care and low physical and mental well-being among people with diabetes and chronic kidney disease (CKD). METHODS: Adults with diabetes and CKD (estimated Glomerular Filtration Rate < 60 ml/min/1.73m(2)) were recruited and completed a questionnaire on barriers to health care, the 12-Item HRQoL Short Form Survey and clinical assessment. Low physical and mental health status were defined as mean scores < 50. Logistic regression models were used. RESULTS: Three hundred eight participants (mean age 66.9 +/- 11 years) were studied. Patient reported 'impact of the disease on family and friends' (OR 2.07; 95% CI 1.14 to 3.78), 'feeling unwell' (OR 4.23; 95% CI 1.45 to 12.3) and 'having other life stressors that make self-care a low priority' (OR 2.59; 95% CI 1.20 to 5.61), were all associated with higher odds of low physical health status. Patient reported 'feeling unwell' (OR 2.92; 95% CI 1.07 to 8.01), 'low mood' (OR 2.82; 95% CI 1.64 to 4.87) and 'unavailability of home help' (OR 1.91; 95% CI 1.57 to 2.33) were all associated with higher odds of low mental health status. The greater the number of patient reported barriers the higher the odds of low mental health but not physical health status. CONCLUSIONS: Patient reported barriers to health care were associated with lower physical and mental well-being. Interventions addressing these barriers may improve HRQoL among people with comorbid diabetes and CKD. FAU - Zimbudzi, Edward AU - Zimbudzi E AD - School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. AD - Department of Nephrology, Monash Health, Melbourne, VIC, Australia. FAU - Lo, Clement AU - Lo C AD - School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. AD - Diabetes and Vascular Medicine Unit, Monash Health, Melbourne, VIC, Australia. FAU - Ranasinha, Sanjeeva AU - Ranasinha S AD - School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. FAU - Fulcher, Gregory AU - Fulcher G AD - Department of Diabetes and Endocrinology, Royal North Shore Hospital, Sydney, NSW, Australia. AD - Northern Clinical School, University of Sydney, Royal North Shore Hospital, Sydney, NSW, Australia. FAU - Gallagher, Martin AU - Gallagher M AD - The George Institute for Global Health, University of NSW, Sydney, NSW, Australia. AD - Concord Clinical School, University of Sydney, Sydney, NSW, Australia. FAU - Jan, Stephen AU - Jan S AD - The George Institute for Global Health, University of NSW, Sydney, NSW, Australia. AD - Sydney Medical School, University of Sydney, Sydney, NSW, Australia. FAU - Kerr, Peter G AU - Kerr PG AD - Department of Nephrology, Monash Health, Melbourne, VIC, Australia. AD - Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia. FAU - Teede, Helena J AU - Teede HJ AD - School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. AD - Diabetes and Vascular Medicine Unit, Monash Health, Melbourne, VIC, Australia. FAU - Polkinghorne, Kevan R AU - Polkinghorne KR AD - Department of Nephrology, Monash Health, Melbourne, VIC, Australia. AD - Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia. FAU - Russell, Grant AU - Russell G AD - School of Primary Health and Allied Health Care, Monash University, Melbourne, VIC, Australia. FAU - Walker, Rowan G AU - Walker RG AD - Department of Renal Medicine, Alfred Hospital, Melbourne, VIC, Australia. FAU - Zoungas, Sophia AU - Zoungas S AD - School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. sophia.zoungas@monash.edu. AD - Diabetes and Vascular Medicine Unit, Monash Health, Melbourne, VIC, Australia. sophia.zoungas@monash.edu. AD - The George Institute for Global Health, University of NSW, Sydney, NSW, Australia. sophia.zoungas@monash.edu. LA - eng GR - ID 1055175/National Health and Medical Research Council, Australia (NHMRC) Partnership Grant/ PT - Journal Article DEP - 20181119 PL - England TA - Health Qual Life Outcomes JT - Health and quality of life outcomes JID - 101153626 SB - IM MH - Adult MH - Aged MH - Diabetes Mellitus/*psychology MH - Female MH - *Health Services Accessibility MH - *Health Status MH - Humans MH - Logistic Models MH - Male MH - Middle Aged MH - *Quality of Life MH - Renal Insufficiency, Chronic/complications/*psychology MH - Surveys and Questionnaires PMC - PMC6245917 OTO - NOTNLM OT - Chronic kidney disease OT - Diabetes OT - Health related quality of life OT - Mental well-being OT - Patient reported barriers OT - Physical well-being COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: Approval for the Diabetes Renal Project was obtained from Monash University (CF12/4030-2,012,001,924), Monash Health (12,340 L), Alfred Health (526/12), Royal North Shore Hospital (1212-431 M), University of Sydney (2013/672) and Concord Hospital (LNRSSA/13/CRGH/139). CONSENT FOR PUBLICATION: All eligible patients provided a written informed consent after receiving an explanation of study procedures and aims and after having an opportunity to ask questions. COMPETING INTERESTS: The authors declare that they have no competing interests. PUBLISHER'S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. EDAT- 2018/11/21 06:00 MHDA- 2019/01/30 06:00 PMCR- 2018/11/19 CRDT- 2018/11/21 06:00 PHST- 2018/05/12 00:00 [received] PHST- 2018/11/04 00:00 [accepted] PHST- 2018/11/21 06:00 [entrez] PHST- 2018/11/21 06:00 [pubmed] PHST- 2019/01/30 06:00 [medline] PHST- 2018/11/19 00:00 [pmc-release] AID - 10.1186/s12955-018-1044-2 [pii] AID - 1044 [pii] AID - 10.1186/s12955-018-1044-2 [doi] PST - epublish SO - Health Qual Life Outcomes. 2018 Nov 19;16(1):215. doi: 10.1186/s12955-018-1044-2.