Longitudinal Trends in Quality of Life and Physical Function in Frail Older Dialysis Patients: A Comparison of Assisted Peritoneal Dialysis and In-Center Hemodialysis

Background In-center hemodialysis (HD) has been the standard treatment for older dialysis patients, but reports suggest an associated decline in physical and cognitive function. Cross-sectional data suggest that assisted peritoneal dialysis (aPD), an alternative treatment, is associated with quality of life (QoL) outcomes that are comparable to in-center HD. We compared longitudinal changes in QoL between modalities. Methods We enrolled 106 aPD patients, matched with 100 HD patients from 20 renal centers in England and Northern Ireland. Patients were assessed quarterly for 2 years using the Hospital Anxiety and Depression Scale (HADS), SF-12 physical and mental scores, symptom score, Illness Intrusiveness Rating Scale (IIRS), Barthel's score, and the Renal Treatment Satisfaction Questionnaire (RTSQ). Mixed model analysis was used to assess the impact of dialysis modality on these outcomes during follow-up. P values were adjusted for multiple significance testing. Results Multivariate analysis showed no difference in any of the outcome measures between aPD and HD. Longitudinal trends in outcomes were also not significantly different. Higher age at baseline was associated with lower IIRS and RTSQ scores during follow-up. One-hundred and twenty-five (60.6%) patients dropped out of the study: 59 (28.6%) died, 61 (29.6%) withdrew during follow-up, and 5 (2.5%) were transplanted. Conclusions Quality of life outcomes in frail older aPD patients were equivalent to those receiving in-center HD. Assisted PD is thus a valid alternative to HD for older people with end-stage kidney disease (ESKD) wishing to dialyze at home.

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P1547THE EFFECT OF INTERNET-BASED CLOSED-LOOP MANAGEMENT ON QUALITY OF LIFE IN PATIENTS ON PERITONEAL DIALYSIS, A SELF-CONTROL STUDY

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p1547 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Fang Cao

Keyword(s):

Quality Of Life ◽

Peritoneal Dialysis ◽

Management System ◽

Closed Loop ◽

Health Management ◽

Management Model ◽

Self Management ◽

Dialysis Patients

Abstract Background and Aims With the continuous advancement of information technology, mobile Internet has entered every family and shown its unique advantages. The development of hospital's information construction on the management of chronic disease, the continuous improvement of hospital APP and Wechat public number functions have provided intelligent services for patients throughout the process. Along with this process, the way of hospital patient follow-up has gradually expanded and improved, and the automation and intellectualization of follow-up work has become a reality. However, The establishment of peritoneal dialysis health management professional team and the implementation of closed-loop health management model, which is based on the Internet closed-loop management model has no clear impact on the self-management ability, quality of life and treatment effect of peritoneal dialysis patients. To explore the effectiveness of Internet based in-hospital and out of hospital closed loop management on the quality of life of patients with peritoneal dialysis, it is necessary to establish a set of closed loop management system for chronic diseases patients with promotion and practical significance. Method From July 2017 to July 2018, 214 patients with continuous peritoneal dialysis were followed up regularly in the Department of Nephrology of our hospital, and voluntarily participated in this study. The mean follow-up time was 12.6 ± 1.5 months. The differences of blood electrolytes, quality control indexes, self-management ability, quality of life of renal disease and hospital satisfaction were observed before and after closed-loop management. Results Ability of self-management behavior (p < 0.001), quality of life (p < 0.001), satisfaction (p < 0.001), the incidence of infection (p < 0.05), serum albumin (p < 0.05), hemoglobin (p < 0.05)were improved after participating in the closed-loop management. Conclusion The closed-loop management system based on Internet closed-loop management model is effective for the quality of life and treatment effect of peritoneal dialysis patients, which integrates the core functions of follow-up records, intelligent early warning, doctor-patient communication and health education. Through this closed-loop management, medical staff can digitally collect, store, transmit and process the information of in-hospital and out-of-hospital conditions through follow-up analysis, health guidance and remote assistance to achieve the purpose of patient health management. This study shows that this closed-loop management system can effectively manage the health of peritoneal dialysis patients, and provides a replicable model for the management of chronic diseases. Therefore, a comprehensive closed-loop management system based on mobile Internet and information technology, with clinical care as the leading factor and peritoneal dialysis patients as the terminal is a feasible and acceptable follow-up management method for peritoneal dialysis patients and hospitals.

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Psychological Profiles of Chinese Patients With Hemodialysis During the Panic of Coronavirus Disease 2019

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.616016 ◽

2021 ◽

Vol 12 ◽

Author(s):

Zhen-Hua Yang ◽

Xiao-Ting Pan ◽

Yu Chen ◽

Lu Wang ◽

Qiu-Xin Chen ◽

...

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Health Status ◽

Initial Study ◽

Hemodialysis Patients ◽

Dialysis Patients ◽

Follow Up Study ◽

The Impact

Background: Hemodialysis patients not only suffer from somatic disorders but are also at high risks of psychiatric problems. Early this year, the outbreak of coronavirus disease 2019 (COVID-19) has caused great panic and anxiety worldwide. The impact of this acute public health event on the psychological status of hemodialysis patients and its relationship with their quality of life have not been fully investigated.Methods: This study comprised two parts. The initial study enrolled maintenance hemodialysis patients treated in Ruijin Hospital for more than 3 months from March to May 2020 during the ongoing COVID-19 pandemic. Patients completed three questionnaires including the Impact of Events Scale–Revised (IES-R), General Health Questionnaire-28 (GHQ-28), and Kidney Disease Quality of Life (KDQOL) Short Form (SF). Follow-up study was performed from December 2020 to January 2021, when the pandemic of COVID-19 has been effectively contained in China. Only patients enrolled in the initial study were approached to participate in the follow-up study.Results: There were 273 maintenance dialysis patients enrolled in the initial study and 247 finished the follow-up study. For the initial study, the estimated prevalence of nonspecific psychiatric morbidity was 45.8% (125/273) by GHQ-28. By IES-R, 53/273 (19.4%) patients presented with total scores above 24 that reflected clinical concerns. We found a significant difference regarding KDQOL scores between patients with different stress response (IES-R) groups (p = 0.026). Our follow-up study showed that KDQOL and SF-36 scores were significantly improved in comparison with those in the initial study (p = 0.006 and p = 0.031, respectively). Though total scores of GHQ-28 and IES-R did not change significantly, some subscales improved with statistical significance. Furthermore, gender, education background, and duration of hemodialysis were three factors that may affect patients' mental health, quality of life, or health status while dialysis duration was the only variable that correlated with those parameters. However, these correlations were combined effects of the COVID-19 pandemic and the dialysis itself.Conclusions: We found a correlation between changes in the mental health status of dialysis patients and changes in their quality of life. These responses were also mediated by patients' psychosocial parameters. Our results urge the necessity of psychotherapeutic interventions for some patients during this event.

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The impact of symptoms on health-related quality of life in elderly pre-dialysis patients: effect and importance in the EQUAL study

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfy167 ◽

2018 ◽

Vol 34 (10) ◽

pp. 1707-1715 ◽

Cited By ~ 3

Author(s):

Pauline W M Voskamp ◽

Merel van Diepen ◽

Marie Evans ◽

Fergus J Caskey ◽

Claudia Torino ◽

...

Keyword(s):

Quality Of Life ◽

Clinical Decision Making ◽

Dialysis Patients ◽

Symptom Index ◽

Substantial Impact ◽

Stage 4 ◽

Ckd Stage ◽

The Impact

Abstract Background Quality of life (QoL) is an important outcome in chronic kidney disease (CKD). Patients feel that symptoms are an important determinant of QoL. However, this relation is unknown. The aims of this study were to investigate the impact of the number and severity of symptoms on QoL in elderly pre-dialysis patients, assessed by both the effect of symptoms and their importance relative to kidney function, and other clinical variables on QoL. Methods The European Quality study (EQUAL study) is an ongoing European prospective follow-up study in late Stage 4/5 CKD patients aged ≥65 years. We used patients included between March 2012 and December 2015. Patients scored their symptoms with the Dialysis Symptom Index, and QoL with the research and development-36 (RAND-36) item Health Survey (RAND-36). The RAND-36 results in a physical component summary (PCS) and a mental component summary (MCS). We used linear regression to estimate the relation between symptoms and QoL at baseline and after 6 months, and to calculate the variance in QoL explained by symptoms. Results The baseline questionnaire was filled in by 1079 (73%) patients (median age 75 years, 66% male, 98% Caucasian), and the follow up questionnaire by 627 (42%) patients. At baseline, every additional symptom changed MCS with −0.81 [95% confidence interval (CI): −0.91 to −0.71] and PCS with −0.50 (95% CI: −0.62 to −0.39). In univariable analyses, number of symptoms explained 22% of MCS variance and 11% of PCS variance, whereas estimated glomerular filtration rate only explained 1%. Conclusions In elderly CKD Stage 4/5 patients, symptoms have a substantial impact on QoL. This indicates symptoms should have a more prominent role in clinical decision-making.

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Management of Older Outpatients during the COVID-19 Pandemic: The GeroCovid Ambulatory Study

Gerontology ◽

10.1159/000516969 ◽

2021 ◽

pp. 1-6

Author(s):

Pietro Gareri ◽

Stefano Fumagalli ◽

Alba Malara ◽

Enrico Mossello ◽

Caterina Trevisan ◽

...

Keyword(s):

Quality Of Life ◽

Home Care ◽

Rating Scale ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Cognitive Disorders ◽

Well Being ◽

Home Care Services ◽

The Impact

Objectives: The GeroCovid Study is a multi-setting, multinational, and multi-scope registry that includes the GeroCovid home and outpatients’ care cohort. The present study aims to evaluate whether outpatient and home care services with remote monitoring and consultation could mitigate the impact of the COVID-19 pandemic on mental and affective status, perceived well-being, and personal capabilities of outpatients and home care patients with cognitive disorders. Methods: Prospectively recorded patients in an electronic web registry provided by BlueCompanion Ltd. Up to October 31, 2020, the sample included 90 patients receiving regular care from the Center for Cognitive Disorders and Dementia in Catanzaro Lido, Italy. It was made of 52 ambulatory outpatients and 38 home care patients, mean age 83.3 ± 7.54 years. Participants underwent a multidimensional assessment at baseline (T0) and after 90 days (T1). For each patient, we administered the Mini-Mental State Examination (MMSE) for cognitive functions, the Activities of Daily Living (ADL) and Instrumental ADL (IADL) scales for functional capabilities, the Cumulative Illness Rating Scale (CIRS) for comorbidities and their impact on patients’ health, the 5-items Geriatric Depression Scale (GDS) for mood, and the Euro Quality of Life (EuroQoL) for perceived quality of life. Contacts with both ambulatory and home care patients were managed in person or via telephone, preferably through video calls (WhatsApp or FaceTime). Results: Contacts with patients were kept at T0 through telephone. At T1, visits were made in person for over 95% out of the cases. The ADL, IADL, CIRS, GDS, MMSE, and EuroQoL changed slightly between T0 and T1. Most of the patients were clinically stable over time on the majority of the scales explored, but behavioral changes were found in 24.4% of patients and anxiety and insomnia in 17.7% of patients. Conclusion: Our study suggests that contacts through telephone and video consultations are likely associated with a health status preservation of the patients.

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Investigation of quality of life in obese adolescents: the effect of psychiatric symptoms of obese adolescent and/or mother on quality of life

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2021-0435 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Ümit Işık ◽

Büşra Bağcı ◽

Faruk Kılıç ◽

Evrim Aktepe ◽

Mustafa Özgür Pirgon

Keyword(s):

Quality Of Life ◽

Rating Scale ◽

Psychiatric Symptoms ◽

Short Form ◽

Depression Scale ◽

Parent Rating ◽

Obese Adolescent ◽

Obese Adolescents ◽

The Impact

Abstract Objectives The present study assessed the obese adolescents’ health-related quality of life (HRQoL) based on both adolescent-reported and maternal-reported questionnaires to clarify adolescent-related psychiatric factors, maternal psychiatric factors, and body mass index (BMI) percentile variables that independently affect the quality of life (QoL). Methods A total of 190 adolescents (120 females and 70 males) were included in the study. The impact of clinical and psychiatric factors on the Pediatric Quality of Life Inventory-Child Version (PedsQL-C) scores was analyzed using hierarchical linear regression methods. Results The final models showed that only the Revised Child Anxiety and Depression Scale-Child Version major depressive disorder scores negatively predicted the physical, psychosocial, and total health scores of the PedsQL-C. The psychosocial scores of the PedsQL-P were negatively predicted by the Strengths and Difficulties Questionnaire emotional, and Conners’ Parent Rating Scale-Revised-Short Form (CPRS-R-S) attention-deficit/hyperactivity disorder (ADHD) index scores. The PedsQL-P total scores were negatively predicted by the CPRS-R-S ADHD index scores. Conclusions The findings of this study indicate that the adolescents’ psychiatric symptoms and BMI percentile played a significant role in the PedsQL subscale functioning of obese adolescents compared to maternal psychiatric symptoms.

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Impact of quality of life on the compliance in hemodialysis and peritoneal dialysis patients in Qassim, Saudi Arabia

International Journal of Medicine in Developing Countries ◽

10.24911/ijmdc.51-1605712662 ◽

2021 ◽

pp. 146-151

Author(s):

Albatool Almousa ◽

Fai Almarshud ◽

Razan Almasuood ◽

Marya Alyahya ◽

Chandra Kalevaru ◽

...

Keyword(s):

Quality Of Life ◽

Saudi Arabia ◽

Peritoneal Dialysis ◽

Dialysis Patients

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The effect of surgery in tenosynovial giant cell tumours as measured by patient-reported outcomes on quality of life and joint function

The Bone & Joint Journal ◽

10.1302/0301-620x.101b3.bjj-2018-0804.r1 ◽

2019 ◽

Vol 101-B (3) ◽

pp. 272-280 ◽

Cited By ~ 3

Author(s):

F. G. M. Verspoor ◽

M. J. L. Mastboom ◽

G. Hannink ◽

W. T. A. van der Graaf ◽

M. A. J. van de Sande ◽

...

Keyword(s):

Quality Of Life ◽

Giant Cell ◽

Diffuse Type ◽

Joint Function ◽

Population Means ◽

Sf 36 ◽

Patient Reported ◽

The Impact

Aims The aim of this study was to evaluate health-related quality of life (HRQoL) and joint function in tenosynovial giant cell tumour (TGCT) patients before and after surgical treatment. Patients and Methods This prospective cohort study run in two Dutch referral centres assessed patient-reported outcome measures (PROMs; 36-Item Short-Form Health Survey (SF-36), visual analogue scale (VAS) for pain, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)) in 359 consecutive patients with localized- and diffuse-type TGCT of large joints. Patients with recurrent disease (n = 121) and a wait-and-see policy (n = 32) were excluded. Collected data were analyzed at specified time intervals preoperatively (baseline) and/or postoperatively up to five years. Results A total of 206 TGCT patients, 108 localized- and 98 diffuse-type, were analyzed. Median age at diagnosis of localized- and diffuse-type was 41 years (interquartile range (IQR) 29 to 49) and 37 years (IQR 27 to 47), respectively. SF-36 analyses showed statistically significant and clinically relevant deteriorated preoperative and immediate postoperative scores compared with general Dutch population means, depending on subscale and TGCT subtype. After three to six months of follow-up, these scores improved to general population means and continued to be fairly stable over the following years. VAS scores, for both subtypes, showed no statistically significant or clinically relevant differences pre- or postoperatively. In diffuse-type patients, the improvement in median WOMAC score was statistically significant and clinically relevant preoperatively versus six to 24 months postoperatively, and remained up to five years’ follow-up. Conclusion Patients with TGCT report a better HRQoL and joint function after surgery. Pain scores, which vary hugely between patients and in patients over time, did not improve. A disease-specific PROM would help to decipher the impact of TGCT on patients’ daily life and functioning in more detail. Cite this article: Bone Joint J 2019;101-B:272–280.

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P181 Long-term improvement in axial spondyloarthritis clinical outcomes following 2-weeks of intensive education and rehabilitation: results from the Bath residential rehabilitation programme

Rheumatology ◽

10.1093/rheumatology/keab247.176 ◽

2021 ◽

Vol 60 (Supplement_1) ◽

Author(s):

Rosie Barnett ◽

Anita McGrogan ◽

Matthew Young ◽

Charlotte Cavill ◽

Mandy Freeth ◽

...

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Disease Activity ◽

Axial Spondyloarthritis ◽

Rehabilitation Programme ◽

Spinal Mobility ◽

The Impact

Abstract Background/Aims Axial spondyloarthritis (axSpA) is a chronic rheumatic condition, characterised by inflammatory back pain - often associated with impaired function and mobility, sleep disturbance, fatigue, and reduced quality of life. Despite the vast advances in pharmacological treatments for axSpA over the last few decades, physical activity and rehabilitation remain vital for effective disease management. At the Royal National Hospital for Rheumatic Diseases in Bath (RNHRD), the 2-week inpatient axSpA rehabilitation programme has been integral to axSpA care since the 1970’s. Prior research has demonstrated significant short-term improvements in spinal mobility (BASMI), function (BASFI) and disease activity (BASDAI) following course attendance. However, the long-term outcomes are yet to be evaluated in this unique cohort. Methods Since the early 1990’s, clinical measures of spinal mobility, function and disease activity have been routinely collected at the RNHRD at all clinical appointments through administration of the BASMI, BASFI and BASDAI, respectively. Dates of attending the axSpA course and standard clinical and treatment follow-up data were also collected. Multiple linear regression models were used to investigate the impact of course attendance on final reported BASMI, BASDAI and BASFI scores (final score=most recent). Length of follow-up was defined as time between first and last recorded BASMI. Results Of the 203 patients within the Bath SPARC200 cohort, 77.8% (158/203) had attended at least one rehabilitation course throughout follow-up. 70.0% (140/203) of patients were male. The mean duration of follow-up was 13.5 years (range 0-35 years); 28.1% (57/203) of individuals with 20+ years of follow-up. Course attendance (yes versus no) significantly reduced final BASMI score by 0.84 (p = 0.001, 95%CI -1.31 to -0.37) and final BASDAI score by 0.74 (p = 0.018, 95%CI -1.34 to -0.13). Although course attendance reduced final BASFI by 0.45 (95%CI -1.17 to 0.28), this relationship did not reach significance (p = 0.225). Whilst minimally clinically important difference (MCID) is, to our knowledge, yet to be defined for BASMI, MCIDs were achieved long-term for both BASDAI and BASFI - defined by van der Heijde and colleagues in 2016 as 0.7 and 0.4 for BASDAI and BASFI, respectively. Conclusion These results provide novel evidence to support the integral role of education, physical activity and rehabilitation in the management of axSpA. Future work should investigate additional outcomes of critical importance to patients and clinicians, such as fatigue, quality of life and work productivity. Furthermore, a greater understanding of the factors that confound these outcomes may provide insights into those patients who may most benefit from attending a 2-week rehabilitation course. In addition to facilitating identification of those patients who may require additional clinical support. Disclosure R. Barnett: None. A. McGrogan: None. M. Young: None. C. Cavill: None. M. Freeth: None. R. Sengupta: Honoraria; Biogen, Celgene, AbbVie, Novartis, MSD. Grants/research support; Novartis, UCB.

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Psychiatric and psychosocial morbidity 1 year after epilepsy surgery

Irish Journal of Psychological Medicine ◽

10.1017/ipm.2020.114 ◽

2020 ◽

pp. 1-8

Author(s):

S. Patel ◽

M. Clancy ◽

H. Barry ◽

N. Quigley ◽

M. Clarke ◽

...

Keyword(s):

Quality Of Life ◽

Surgical Treatment ◽

Epilepsy Surgery ◽

Refractory Epilepsy ◽

Post Surgery ◽

Axis I ◽

Patients With Epilepsy ◽

The Impact

Abstract Objectives: There is a high rate of psychiatric comorbidity in patients with epilepsy. However, the impact of surgical treatment of refractory epilepsy on psychopathology remains under investigation. We aimed to examine the impact of epilepsy surgery on psychopathology and quality of life at 1-year post-surgery in a population of patients with epilepsy refractory to medication. Methods: This study initially assessed 48 patients with refractory epilepsy using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), the Hospital Anxiety and Depression Scale (HADS) and the Quality of Life in Epilepsy Inventory 89 (QOLIE-89) on admission to an Epilepsy Monitoring Unit (EMU) as part of their pre-surgical assessment. These patients were again assessed using the SCID-I, QOLIE-89 and HADS at 1-year follow-up post-surgery. Results: There was a significant reduction in psychopathology, particularly psychosis, following surgery at 1-year follow-up (p < 0.021). There were no new cases of de novo psychosis and surgery was also associated with a significant improvement in the quality of life scores (p < 0.001). Conclusions: This study demonstrates the impact of epilepsy surgery on psychopathology and quality of life in a patient population with refractory surgery. The presence of a psychiatric illness should not be a barrier to access surgical treatment.

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The course of peripheral neuropathy and its association with health-related quality of life among colorectal cancer patients

Journal of Cancer Survivorship ◽

10.1007/s11764-020-00923-6 ◽

2020 ◽

Author(s):

Cynthia S. Bonhof ◽

Lonneke V. van de Poll-Franse ◽

Dareczka K. Wasowicz ◽

Laurens V. Beerepoot ◽

Gerard Vreugdenhil ◽

...

Keyword(s):

Quality Of Life ◽

Colorectal Cancer ◽

Peripheral Neuropathy ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

Eortc Qlq ◽

The Impact

Abstract Purpose To gain more insight into the course of chemotherapy-induced peripheral neuropathy (CIPN) and its impact on health-related quality of life (HRQoL) in a population-based sample of colorectal cancer (CRC) patients up to 2 years after diagnosis. Methods All newly diagnosed CRC patients from four hospitals in the Netherlands were eligible for participation in an ongoing prospective cohort study. Patients (n = 340) completed questions on CIPN (EORTC QLQ-CIPN20) and HRQoL (EORTC QLQ-C30) before initial treatment (baseline) and 1 and 2 years after diagnosis. Results Among chemotherapy-treated patients (n = 105), a high sensory peripheral neuropathy (SPN) level was reported by 57% of patients at 1 year, and 47% at 2-year follow-up, whereas a high motor peripheral neuropathy (MPN) level was reported by 47% and 28%, at years 1 and 2, respectively. Linear mixed model analyses showed that SPN and MPN symptoms significantly increased from baseline to 1-year follow-up and did not return to baseline level after 2 years. Patients with a high SPN or MPN level reported a worse global quality of life and a worse physical, role, emotional, cognitive, and social functioning compared with those with a low SPN or MPN level. Conclusions Future studies should focus on understanding the mechanisms underlying CIPN so targeted interventions can be developed to reduce the impact of CIPN on patient’s lives. Implications for cancer survivors Patients need to be informed of both CIPN and the impact on HRQoL.

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