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Assessment of treatment burden and its impact on quality of life in dialysis-dependent and pre-dialysis chronic kidney disease patients
Research in Social and Administrative Pharmacy ( IF 3.348 ) Pub Date : 2021-02-13 , DOI: 10.1016/j.sapharm.2021.02.010
Asmaa Al-Mansouri 1 , Fadwa Saqr Al-Ali 2 , Abdullah Ibrahim Hamad 2 , Mohamed Izham Mohamed Ibrahim 3 , Nadir Kheir 4 , Rania Abdelaziz Ibrahim 2 , Muna AlBakri 1 , Ahmed Awaisu 3
Affiliation  

Background

The management of chronic kidney disease (CKD) and its complications places a significant burden on patients, resulting in impairment of their health-related quality of life (HR-QOL). Little is known about treatment-related burden in pre-dialysis and hemodialysis (HD) CKD patients.

Objective

This study aimed to investigate the magnitude of treatment-related burden and its impact on HR-QOL among patients with CKD.

Methods

This was a prospective, cross-sectional study to assess treatment-related burden and HR-QOL among patients with CKD in Qatar. Treatment-related burden and HR-QOL were assessed quantitatively using the Treatment Burden Questionnaire (TBQ) and the Kidney Disease Quality of Life (KDQOL™) questionnaire, respectively. The total TBQ score ranges from 0 to 150, with a higher score indicating higher treatment burden, while the range of total possible scores for the KDQOL™ are from 0 to 3600 with higher transformed score indicating better QOL. Pre-dialysis and hemodialysis (HD) CKD patients who had regular follow-up appointments at Fahad Bin Jassim Kidney Center in Qatar were enrolled. Data were analyzed descriptively and inferentially using SPSS version-24.

Results

Two hundred-eighty CKD patients (HD = 223 and pre-dialysis = 57) were included in the analyses (response rate 60.9%). Approximately 35% of the participants reported moderate to high treatment-related burden (TBQ global score 51–150). HD patients experienced significantly higher treatment burden compared to pre-dialysis patients with a median (IQR) score of 45 (36) versus 25 (33), respectively (p < 0.001). Medication burden and lifestyle changes burden were the highest perceived treatment-related burden. Overall, the perceived median (IQR) HR-QOL measured using the KDQOL-36™ among the participants was 2280.6 (1096.2) compared to the maximum global score of 3600. Similarly, the HD patients demonstrated significantly lower HR-QOL compared to the pre-dialysis patients [median (IQR) score of 2140 (1100) vs. 2930 (995), respectively; p < 0.001). There was a strong negative correlation between TBQ score and KDQOL-36™ score [rs (251) = −0.616, p < 0.001], signifying that HR-QOL decreases as treatment burden increases.

Conclusions

This study suggests that a considerable proportion of CKD patients suffered from treatment-related burden and deterioration in HR-QOL at a varying degree of seriousness. HD patients experienced significantly higher burden of treatment and lower HR-QOL compared to pre-dialysis patients and that HR-QOL declines as treatment burden increases. Therefore, treatment-related burden should be considered in CKD management and factors that increase it should be considered when designing healthcare interventions directed to CKD patients.



中文翻译:

透析依赖和透析前慢性肾脏病患者的治疗负担及其对生活质量的影响评估

背景

慢性肾病 (CKD) 及其并发症的管理给患者带来了重大负担,导致他们的健康相关生活质量 (HR-QOL) 受损。对透析前和血液透析 (HD) CKD 患者的治疗相关负担知之甚少。

客观的

本研究旨在调查 CKD 患者治疗相关负担的程度及其对 HR-QOL 的影响。

方法

这是一项前瞻性横断面研究,旨在评估卡塔尔 CKD 患者的治疗相关负担和 HR-QOL。治疗相关负担和 HR-QOL 分别使用治疗负担问卷 (TBQ) 和肾脏疾病生活质量 (KDQOL™) 问卷进行定量评估。TBQ 总分范围为 0 至 150,分数越高表示治疗负担越重,而 KDQOL™ 的总可能分数范围为 0 至 3600,转换分数越高表示 QOL 越好。纳入了在卡塔尔 Fahad Bin Jassim 肾脏中心定期随访的透析前和血液透析 (HD) CKD 患者。使用 SPSS 24 版对数据进行描述性和推理性分析。

结果

280 名 CKD 患者(HD = 223 和透析前 = 57)被纳入分析(反应率 60.9%)。大约 35% 的参与者报告了中度至高度的治疗相关负担(TBQ 全球评分 51-150)。与透析前患者相比,HD 患者经历了显着更高的治疗负担,中位数 (IQR) 评分分别为 45 (36) 和 25 (33) (p < 0.001)。药物负担和生活方式改变负担是最高的与治疗相关的负担。总体而言,参与者中使用 KDQOL-36™ 测量的感知中位数 (IQR) HR-QOL 为 2280.6 (1096.2),而最高全球评分为 3600。同样,与前相比,HD 患者的 HR-QOL 显着降低。 -透析患者 [中位 (IQR) 评分分别为 2140 (1100) 和 2930 (995);p < 0.001)。

结论

该研究表明,相当大比例的 CKD 患者遭受不同严重程度的治疗相关负担和 HR-QOL 恶化。与透析前患者相比,HD 患者经历了显着更高的治疗负担和更低的 HR-QOL,并且 HR-QOL 随着治疗负担的增加而下降。因此,在 CKD 管理中应考虑与治疗相关的负担,在设计针对 CKD 患者的医疗干预措施时,应考虑增加负担的因素。

更新日期:2021-02-13
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