Effect of intensive glycemic lowering on health-related quality of life in type 2 diabetes: ACCORD trial.
Effect of intensive glycemic lowering on health-related quality of life in type 2 diabetes: ACCORD trial.
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DOI：
10.2337/dc10-1926
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发表时间：
2011-04
期刊：
影响因子：
16.2
通讯作者：
Action to Control Cardiovascular Risk in Diabetes (ACCORD) Investigators
中科院分区：
文献类型：
--
作者：
Anderson RT;Narayan KM;Feeney P;Goff D Jr;Ali MK;Simmons DL;Sperl-Hillen JA;Bigger T;Cuddihy R;O'Conner PJ;Sood A;Zhang P;Sullivan MD;Action to Control Cardiovascular Risk in Diabetes (ACCORD) Investigators
在控制糖尿病心血管风险措施（雅阁）试验的一项子研究中，比较强化与标准血糖控制策略对健康相关生活质量（HRQL）的影响。在基线和12个月、36个月和48个月访视时，对随机选择的2，053例入组HRQL子研究的雅阁参与者进行了评估。HRQL评估包括一般健康状况（36项简明健康调查表[SF-36]）、糖尿病症状（糖尿病症状困扰检查表）、抑郁（患者健康问卷[PHQ]-9）和治疗满意度（糖尿病治疗满意度问卷[DTSQ]）。使用重复测量ANOVA模型估计48个月内各治疗组HRQL结局的变化，调整模型协变量。探讨了提前停用雅阁强化血糖控制组对研究结果的影响。共有1，956例（95%）在基线时完成了自我报告HRQL工具。强化组SF-36身体健康部分评分的下降幅度大于标准组（-1.6 vs.-1.1，P = 0.0345）。治疗满意度（DTSQ）显示强化治疗的改善幅度大于标准治疗（P = 0.0004）。糖尿病症状自评量表和PHQ-9的平均评分无差异。强化治疗组中止后受试者的转换对HRQL的影响不显著。雅阁试验的强化血糖控制策略并未导致HRQL获益，但与糖尿病治疗满意度的适度改善相关。因此，患者的可接受性显然不会受到密集和复杂干预措施（如雅阁中使用的干预措施）的影响。
To compare the effect of intensive versus standard glycemic control strategies on health-related quality of life (HRQL) in a substudy of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. A randomly selected subsample of 2,053 ACCORD participants enrolled in the HRQL substudy was assessed at baseline and 12-, 36-, and 48-month visits. HRQL assessment included general health status (the 36-Item Short Form Health Survey [SF-36]), diabetes symptoms (the Diabetes Symptom Distress Checklist), depression (Patient Health Questionnaire [PHQ]-9), and treatment satisfaction (Diabetes Treatment Satisfaction Questionnaire [DTSQ]). Repeated-measures ANOVA models were used to estimate change in HRQL outcomes by treatment group over 48 months adjusting for model covariates. The effects of early discontinuation of the ACCORD intensive glycemic control arm on study results were explored. A total of 1,956 (95%) completed the self-report HRQL instrument(s) at baseline. The intensive arm had a larger decrease in SF-36 physical health component score than the standard arm (−1.6 vs. −1.1, P = 0.0345). Treatment satisfaction (DTSQ) showed larger improvement with intensive than standard (P = 0.0004). There were no differences in mean scores of the Diabetes Symptom Checklist and PHQ-9. Effects of participant transition following discontinuation of the intensive arm on HRQL were not significant. The ACCORD trial strategy of intensive glycemic control did not lead to benefits in HRQL and was associated with modest improvement in diabetes treatment satisfaction. Thus patient acceptability was apparently not compromised with intensive and complex interventions such as those used in ACCORD.
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影响因子：
16.2
作者：
Riddle MC;Ambrosius WT;Brillon DJ;Buse JB;Byington RP;Cohen RM;Goff DC Jr;Malozowski S;Margolis KL;Probstfield JL;Schnall A;Seaquist ER;Action to Control Cardiovascular Risk in Diabetes Investigators
通讯作者：
Action to Control Cardiovascular Risk in Diabetes Investigators
影响因子：
7.2
作者：
Gulliford, MC;Mahabir, D
通讯作者：
Mahabir, D
影响因子：
158.5
作者：
Gerstein, Hertzel C.;Miller, Michael E.;Friedewald, William T.
通讯作者：
Friedewald, William T.
影响因子：
2.8
作者：
Buse, John B.
通讯作者：
Buse, John B.
影响因子：
3.5
作者：
Wikblad, K;Leksell, J;Wibell, L
通讯作者：
Wibell, L