METHODS: Data were obtained from the 2012 Japan (N=30,000) National Health and Wellness Survey (NHWS) and 2013 China (N=19,987) NHWS, administered on-line to representative adult samples (18+ years). Generalized linear models and Tukey’s HSD procedure were used to estimate differences between respondents without diabetes (Japan n=25,338; China n = 16,816), respondents with Type 2 diabetes without complications (Japan n=929; China n=408), and respondents with Type 2 diabetes with complications (Japan n = 125; China n = 184). Respondent age, sex, and BMI served as covariates in all models. The SF-36 and the WPAI were used to measure health status and utilities and work productivity respectively.

RESULTS: : The relationship between the patient reported outcomes of mental and physical health status, level of depression, health utilities, work productivity, activity impairment, days missed from work and level of diabetic condition was consistent. Diabetic complications were associated with greater levels of health/activity/work impairment and lower health utilities (p < .0001 for all comparisons). Chinese respondents reported greater levels of impairment and lower health utilities relative to Japanese respondents (p < .0001 for all comparisons).

CONCLUSIONS: : The patient voice varies across countries, cultures, and conditions. Treating the whole patient versus treating only the presenting disease requires a shift in how healthcare is delivered and medical decisions are made. Patients can provide reliable and valid information regarding their health and wellness status through the use of validated methods and tools. Amplifying the patient voice and integrating it with clinical expertise may be the best way maximize the positive outcomes for the patient.