Aoife C Lowney1, Helena T Myles2, Katherine Bristowe3, Eanna L Lowney4, Katie Shepherd3, Marie Murphy5, Tony O'Brien6, Liam Casserly7, Regina McQuillan8, William D Plant9, Peter J Conlon10, Catherine Vinen11, Joseph A Eustace12, Fliss E M Murtagh3. 1. Department of Palliative Medicine, Marymount University Hospital & Hospice, Cork, Ireland; Department of Palliative Medicine, Cork University Hospital, Cork, Ireland. Electronic address: aoifelowney@gmail.com. 2. Department of Palliative Medicine, Beaumont Hospital, Dublin, Ireland. 3. Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, King's College London, London, United Kingdom. 4. College of Medicine and Health at University College Cork, Cork, Ireland. 5. Department of Palliative Medicine, Marymount University Hospital & Hospice, Cork, Ireland. 6. Department of Palliative Medicine, Marymount University Hospital & Hospice, Cork, Ireland; Department of Palliative Medicine, Cork University Hospital, Cork, Ireland; College of Medicine and Health at University College Cork, Cork, Ireland. 7. Department of Renal Medicine, Limerick University Hospital, Limerick, Ireland. 8. Department of Palliative Medicine, St Francis Hospice, Raheny, Dublin, Ireland. 9. College of Medicine and Health at University College Cork, Cork, Ireland; Department of Renal Medicine, Cork University Hospital, Cork, Ireland. 10. Department of Renal Medicine, Beaumont Hospital Dublin, Dublin, Ireland; Royal College of Surgeons in Ireland, Dublin, Ireland. 11. Department of Renal Medicine, Kings College Hospital NHS Foundation Trust, London, United Kingdom. 12. College of Medicine and Health at University College Cork, Cork, Ireland; Department of Renal Medicine, Cork University Hospital, Cork, Ireland; HRB Clinical Research Facility at University College Cork, Cork, Ireland.
Abstract
CONTEXT: The international cohort of hemodialysis patients is aging and increasing in number. Nephrologists have a therapeutic relationship with their patients that may span decades. Often overlooked components of chronic disease management include symptom control and assessment of health-related quality of life (HRQoL). OBJECTIVES: This study describes the symptom profile of a large cohort of patients with end-stage renal disease on hemodialysis in England and Ireland and evaluates how symptom burden and other factors influence quality-of-life scores. METHODS: A prospective cross-sectional observational study of hemodialysis patients was conducted in Ireland and England during 2011 and 2012. Two validated clinical tools were used to determine HRQoL and symptom burden. Demographic and clinical data were examined, and regression analysis was used to determine associations with HRQoL scores. RESULTS: A total of 893 patients on hemodialysis (mean [SD] age 64 [16] years) had a high symptom burden and poor HRQoL compared with population norms. Specifically, 64% of patients reported pain (95% confidence interval 61%-67%) and 79% reported weakness (95% confidence interval 75%-81%). A total of 43 percent of patients reported between six and 10 symptoms in the week preceding the survey. HRQoL was significantly and independently associated with poor mobility and pain and remained significant after adjusting for variations in clinical characteristics. Being listed on a transplant wait-list register was positively associated with HRQoL. CONCLUSION: These findings illustrate the high symptom burden and poor HRQoL of the hemodialysis population. Emphasis during clinical reviews on pain assessment and on assessing mobility plus interventions, such as pain management and physiotherapy/occupational therapy, are practical ways for renal teams to help improve patients' quality of life.
CONTEXT: The international cohort of hemodialysis patients is aging and increasing in number. Nephrologists have a therapeutic relationship with their patients that may span decades. Often overlooked components of chronic disease management include symptom control and assessment of health-related quality of life (HRQoL). OBJECTIVES: This study describes the symptom profile of a large cohort of patients with end-stage renal disease on hemodialysis in England and Ireland and evaluates how symptom burden and other factors influence quality-of-life scores. METHODS: A prospective cross-sectional observational study of hemodialysis patients was conducted in Ireland and England during 2011 and 2012. Two validated clinical tools were used to determine HRQoL and symptom burden. Demographic and clinical data were examined, and regression analysis was used to determine associations with HRQoL scores. RESULTS: A total of 893 patients on hemodialysis (mean [SD] age 64 [16] years) had a high symptom burden and poor HRQoL compared with population norms. Specifically, 64% of patients reported pain (95% confidence interval 61%-67%) and 79% reported weakness (95% confidence interval 75%-81%). A total of 43 percent of patients reported between six and 10 symptoms in the week preceding the survey. HRQoL was significantly and independently associated with poor mobility and pain and remained significant after adjusting for variations in clinical characteristics. Being listed on a transplant wait-list register was positively associated with HRQoL. CONCLUSION: These findings illustrate the high symptom burden and poor HRQoL of the hemodialysis population. Emphasis during clinical reviews on pain assessment and on assessing mobility plus interventions, such as pain management and physiotherapy/occupational therapy, are practical ways for renal teams to help improve patients' quality of life.
Authors: Dena E Cohen; Andrew Lee; Scott Sibbel; Deborah Benner; Steven M Brunelli; Francesca Tentori Journal: BMC Nephrol Date: 2019-04-01 Impact factor: 2.388
Authors: Sarah Elshahat; Paul Cockwell; Alexander P Maxwell; Matthew Griffin; Timothy O'Brien; Ciaran O'Neill Journal: PLoS One Date: 2020-03-24 Impact factor: 3.240
Authors: Emily Duncanson; Paul N Bennett; Andrea Viecelli; Kathryn Dansie; William Handke; Allison Tong; Suetonia Palmer; Shilpanjali Jesudason; Stephen P McDonald; Rachael L Morton Journal: BMJ Open Date: 2020-11-06 Impact factor: 2.692
Authors: Claire Carswell; Joanne Reid; Ian Walsh; William Johnston; Helen McAneney; Robert Mullan; Jenny B Lee; Hugh Nelson; Michael Matthews; Elizabeth Weatherup; Andrea Spencer; Jean Michelo; Anne Quail; Grainne Kielty; Alistair Mackenzie; Jenny Elliott; Nicola Arbuckle; Anna Wilson; Helen Noble Journal: BMC Nephrol Date: 2020-11-19 Impact factor: 2.388