Quality-of-Life and Utility Values Associated With Diabetic Retinopathy in Tanzania.

OBJECTIVES

To estimate health related quality of life, health state utility values, and vision related quality of life (VRQoL) in people with different stages of diabetic retinopathy (DR) in a Tanzanian diabetic population.

METHODS

People living with diabetes aged over 18 were recruited through a DR screening program and from a hospital eye clinic. Participants' health status was assessed using the EuroQol 5-Dimension 5-Level questionnaire and the responses were converted into utility values. VRQoL was assessed using a standardized questionnaire. We conducted a multivariable regression analysis of index scores.

RESULTS

A total of 278 participants were interviewed comprising: 80 with no DR, 67 with non-sight threatening DR, 109 with sight threatening DR, and 22 who were bilaterally blind (<3/60) from DR. The mean utility values for persons with no DR, non-sight-threatening DR and sight-threatening were 0.75 (95% CI 0.69-0.82), 0.69 (95% CI 0.61- 0.77) and 0.61 (95% CI 0.54-0.68), respectively. Blindness from DR (0.23, 95% CI 0.01-0.44) was associated (P < .0001) with a much lower mean utility value compared with participants with no DR. VRQoL scores decreased with increasing severity of DR and non-sight-threatening (P = .015), sight-threatening (P < .0001), and blindness from DR (P < .0001) were all associated with worse VRQoL.

CONCLUSIONS

This study provides estimates of health state utility values for different stages of DR in a Tanzanian diabetic population that can be used in economic evaluations. The substantially lower utility values for persons blind from DR highlights the importance of early detection and treatment of people with sight-threatening DR.