Irish journal of medical science · 2026
Socioeconomic status and medication adherence as determinants of health-related quality of life in patients with diabetes and hypertension.
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Soma Mani Santhosh Nikhil, Vyshnavi J, Bhavin V S, Hoque Johidul, Chinnaeswaraiah M
Аннотация
BACKGROUND: Diabetes mellitus (DM) and hypertension (HTN) are non-communicable diseases that have significant impact on health-related quality of life (HRQoL). Among determinants of outcome, socio-economic status (SES) and medication adherence have not been examined particularly in relation to their joint effect on HRQoL in Indian patients.
OBJECTIVES: To investigate the independent and interactive influences of SES and medication adherence on HRQoL in patients with DM, HTN, or both, and to identify demographic and clinical predictors of poor HRQoL.
METHODS: A cross-sectional analytical observational study was conducted at a tertiary care hospital in Telangana, India, over nine months (August 2024-April 2025). A total of 352 patients aged ≥ 18 years with DM, HTN, or both were enrolled. SES was assessed using the Modified Kuppuswamy Scale, adherence using the Morisky Medication Adherence Scale (MMAS-8), and HRQoL using the Short Form-36 (SF-36). Associations were analyzed using chi-square, one-way, and two-way ANOVA.
RESULTS: Participants had a mean age of 52.8 ± 14.6 years; 59% were male. High adherence was observed in 19%, medium in 41%, and low in 40%. Low SES and poor adherence were significantly associated with reduced HRQoL across SF-36 domains (p < 0.0005). Patients with higher SES and high adherence reported better physical and psychosocial functioning. Older age, obesity, and multimorbidity further reduced HRQoL, while disease duration had minimal impact.
CONCLUSION: SES and adherence independently and synergistically influence HRQoL in DM and HTN patients. Integrated, patient-centered strategies addressing socio-economic barriers and promoting adherence are essential to improve HRQoL in resource-limited settings.
OBJECTIVES: To investigate the independent and interactive influences of SES and medication adherence on HRQoL in patients with DM, HTN, or both, and to identify demographic and clinical predictors of poor HRQoL.
METHODS: A cross-sectional analytical observational study was conducted at a tertiary care hospital in Telangana, India, over nine months (August 2024-April 2025). A total of 352 patients aged ≥ 18 years with DM, HTN, or both were enrolled. SES was assessed using the Modified Kuppuswamy Scale, adherence using the Morisky Medication Adherence Scale (MMAS-8), and HRQoL using the Short Form-36 (SF-36). Associations were analyzed using chi-square, one-way, and two-way ANOVA.
RESULTS: Participants had a mean age of 52.8 ± 14.6 years; 59% were male. High adherence was observed in 19%, medium in 41%, and low in 40%. Low SES and poor adherence were significantly associated with reduced HRQoL across SF-36 domains (p < 0.0005). Patients with higher SES and high adherence reported better physical and psychosocial functioning. Older age, obesity, and multimorbidity further reduced HRQoL, while disease duration had minimal impact.
CONCLUSION: SES and adherence independently and synergistically influence HRQoL in DM and HTN patients. Integrated, patient-centered strategies addressing socio-economic barriers and promoting adherence are essential to improve HRQoL in resource-limited settings.