Health Outcome Measures for Diabetes Mellitus: A Review

To review selective health outcome measures for diabetes mellitus focussing on psychometric properties. Systematic literature search was carried out to identify the instruments using electronic databases and manual search from relevant journals. Health outcome measures were assessed with predefined inclusion and exclusion criteria. Each instrument was assessed for patient related information, instrument content, reliability, validity and responsiveness to change. The electronic and manual search generated 317 relevant references. Twenty seven instruments that met the inclusion criteria were included in the study. Among the 27 instruments, 20 were in English language. Out of these, 14 instruments were developed in USA and the majority of the remaining in UK. The time taken to complete the questionnaires varied from 3-40 minutes. Appraisal of Diabetes Scale and Audit of Diabetes-Dependent Quality of Life are single index instruments and the remaining instruments have dimension in a range of three to nine. Appraisal of Diabetes Scale and Diabetes Treatment Satisfaction Questionnaire are the shortest questionnaire whereas Diabetes Care Profile is the longest. The Diabetes Treatment Satisfaction Questionnaire has more translations followed by Diabetes Medication Satisfaction, Audit of Diabetes-Dependent Quality of Life, Diabetes Health profile, Problem area in diabetes scale and Insulin Treatment Appraisal Scale. All the instruments were assessed for psychometric properties. The Diabetes Care Profile, Diabetes-39, Diabetes Quality of life measure, Diabetes specific Quality of life scale, Diabetes Treatment Satisfaction Questionnaire, Diabetes symptom checklist-Revised and Diabetes Medication Satisfaction instruments have good psychometric properties and may be useful for the researcher interested in diabetes care. Most of the instruments were lacking in responsiveness evaluation and were developed and evaluated mainly in developed countries. There is a need, therefore, to focus future research on health outcome measures on the evaluation of responsiveness.