Diabetes Health Profile

The Diabetes Health Profile (DHP) is a scientifically robust diabetes-specific patient reported outcome measure (PROM) developed to evaluate the health-related quality of life (HRQoL) of people living with Type 1 and Type 2 diabetes aged 16 years and older. It is used in community surveys, research studies, clinical trials, population surveys and educational interventions both in the UK and Europe and completed globally by more than 10,000 patients. The DHP is the diabetes-specific PROM selected by the UK Department of Health for their Long Terms Conditions PROM Pilot Study being carried out by Oxford University(1).

The Diabetes Health Profile (DHP-1)
Based on a conceptual model the DHP-1(2) was developed for people with Type 1 diabetes to assess the impact of living with diabetes has on patients quality of life1. Developed using a multimethod methodology including, in-depth interviews with patients, clinical consensus and extensive psychometric validation, the DHP-1 comprises 32 items  which are summed to provide three domain scores measuring: Psychological distress – (14-items) (dysphoric mood, feelings of hopelessness, irritability, self-harm, feeling of external hostility); Barriers to activity (13-items) (perceived limitation to activity, operant anxiety) and Disinhibited eating (5-items) (lack of eating control, response to food cues and emotional arousal). The observed Flesch Kincaid readability statistic is 5.8 for the DHP-1 and a Flesch reading ease is 74.7. Completion time is approximately 9–12 minutes. The DHP-1 has demonstrates highly satisfactory measurement properties including reliability coefficients > 0.80, construct, convergent and criterion validity and ability to discriminate between patients experiencing hypoglycaemic episodes (3,4).

The Diabetes Health Profile (DHP-1 & DHP-18)
The DHP-18 was developed for people with Type 1 and Type 2 diabetes to measure the impact of living with diabetes on the patient's quality of life(5). It comprises 18 items which capture the three key domains based on a conceptual model and conceptual framework identified for the DHP-1. These are, Psychological distress – 6-items (dysphoric mood, feelings of hopelessness, irritability); Barriers to activity 7-items ( perceived limitation to activity, operant anxiety) and Disinhibited eating 5-items (lack of eating control, response to food cues and emotional arousal). The observed Flesch Kincaid readability statistic is 4.5 for the DHP-1 and a Flesch reading ease is 83.0. Completion time is approximately 5–6 minutes.

The DHP-18 has demonstrated very good measurement properties including reliability coefficient >0.70 and the ability to discriminate between different treatment and patient groups (3,5).

Scoring the DHP
Items are scored using a 4-point Likert-type scale ranging from 0-3. Domain raw scores are transformed to a common score range of 0-100, with 0 representing no dysfunction.

Uses

 * Evaluating health improvement and quality of life
 * Monitoring population quality of life
 * Evaluating health programmes and quality of life
 * Evaluating treatment effectiveness and quality of life
 * Enhancing doctor-patient communication

Language versions
The DHP has been officially adapted for use in 29 languages

Bulgarian, Canada (English), Canada (French), Croatian, Czech, Danish, Finnish, Flemish, French, French (Swiss), German, German (Austrian), German (Swiss), Hungarian, Italian, Italian (Swiss), Mandarin, Netherlands, Norwegian, Polish, Romanian, Slovak, Slovenian, Spanish, Swedish, US (English), US (Spanish), Turkish (for Germany), Waloon

Licensing
Isis Outcomes – an activity within Isis Innovations ltd, the technology transfer company of the University of Oxford, manage the licensing and marketing of the Diabetes Health Profile (DHP)

Key references
1. PROMs Pilot Study, Department of Public Health, University of Oxford

2. The Diabetes Health Profile (DHP): a new instrument for assessing the psychosocial profile of insulin requiring patients - development and psychometric evaluation.

3. Health related quality of life reference values (DHP) in people with diabetes living in France - Entred study, 2001-2003.

4.Factors associated with health-related quality of life in people with type 2 diabetes living in France.

5. Sex inequalities in access to care for patients with diabetes in primary care:questionnaire survey.