The Diabetes Health Profile presented at the London Health 2012

1. London Health 2012
Dr Keith Meadows
DHP Research & Consultancy Ltd
The Diabetes Health Profile –
Developments and
Practical Applications

2. Diabetes in the U.K.
UK Diagnosed
2.9 million
diagnosed with
diabetes by 2011
Diabetes type
The impact
10% of 90% of
people with people with
diabetes have diabetes have
Type 1 Type 2 52% Deaths due cardiovascular disease
Financial 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
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3. Diabetes in the U.K.
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4. The psychological impact of living with
diabetes
The facts
10% according to Diabetes UK, people with
of the
population in
diabetes are twice as likely to
Britain have experience depression…
depression at
any 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
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5. The Diabetes Health profile (DHP-18)
The conceptual model
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6. The Diabetes Health profile
DHP-1
25 In-depth patient Insulin dependent (TYPE 1)
32-items
interviews
Literature review/
Interviews with
clinicians/HCP
DHP-18
Insulin dependent
Insulin requiring
Patient /HCP Oral
review Diet
18-items
Psychometric
testing and
validation
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7. The Diabetes Health Profile (DHP-18)
Ways of administering the DHP-18
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8. For the psychometrician
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9. An international perspective
Over
Using the DHP Type 1 and Type 2
patients
have completed the
DHP-18
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11. Living with diabetes - Interpreting the
DIABETES HEALTH PROFILE (DHP)
DHP domain scores by treatment
3173 modality
Mean
age Disinhibeted
eating
63.9 Psycholigical
55%
distress
91% 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
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12. 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.
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13. Interpreting the Diabetes Health Profile
What does a DHP-18 score mean?
M Minimally
the minimally
I Important important difference
(MID) is the smallest
score difference on
D 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
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14. Interpreting the Diabetes Health Profile
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15. Thank you
For more information
info@dhpresearch.com
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