BACKGROUND AND OBJECTIVES: Individuals receiving in-center hemodialysis experience a high symptom burden that detrimentally affects their quality of life. There are few evidence-based interventions for symptom relief in this population. To stimulate innovation in symptom management, data on patient symptom prioritization and treatment preferences are needed. We undertook this study to (1) identify patient-prioritized symptoms for the development of symptom relief therapies and (2) elicit preferences for treatments among individuals receiving hemodialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a mixed methods study that included focus groups in Carrboro, North Carolina; Tucson, Arizona; and Seattle, Washington and a nationally distributed online survey. Focus group transcripts were analyzed for patterns, and the highest priority symptoms were determined on the basis of frequency and report severity. We used focus group findings to inform survey items. Focus group and survey results were crossvalidated and synthesized for final symptom prioritization. RESULTS: There were 32 participants across three focus groups and 87 survey respondents from 27 states in the United States. The physical symptoms of insomnia, fatigue, muscle cramping, and nausea/vomiting and the mood symptoms of anxiety and depressed mood were reported by participants in all focus groups. Among survey respondents, fatigue (94%), cramping (79%), and body aches (76%) were the most common physical symptoms, and feeling depressed (66%), worried (64%), and frustrated (63%) were the most common mood symptoms. The top-prioritized symptoms were consistent across focus group and survey participants and included the physical symptoms insomnia, fatigue, and cramping and the mood symptoms anxiety, depression, and frustration. Participants indicated that symptom frequency, duration, unpredictability, and social and financial effects factored most heavily into symptom prioritization. CONCLUSIONS: Patients prioritized the physical symptoms of insomnia, fatigue, and cramping and the mood symptoms of anxiety, depression, and frustration as the top symptoms for which to find new therapies.
BACKGROUND AND OBJECTIVES: Individuals receiving in-center hemodialysis experience a high symptom burden that detrimentally affects their quality of life. There are few evidence-based interventions for symptom relief in this population. To stimulate innovation in symptom management, data on patient symptom prioritization and treatment preferences are needed. We undertook this study to (1) identify patient-prioritized symptoms for the development of symptom relief therapies and (2) elicit preferences for treatments among individuals receiving hemodialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a mixed methods study that included focus groups in Carrboro, North Carolina; Tucson, Arizona; and Seattle, Washington and a nationally distributed online survey. Focus group transcripts were analyzed for patterns, and the highest priority symptoms were determined on the basis of frequency and report severity. We used focus group findings to inform survey items. Focus group and survey results were crossvalidated and synthesized for final symptom prioritization. RESULTS: There were 32 participants across three focus groups and 87 survey respondents from 27 states in the United States. The physical symptoms of insomnia, fatigue, muscle cramping, and nausea/vomiting and the mood symptoms of anxiety and depressed mood were reported by participants in all focus groups. Among survey respondents, fatigue (94%), cramping (79%), and body aches (76%) were the most common physical symptoms, and feeling depressed (66%), worried (64%), and frustrated (63%) were the most common mood symptoms. The top-prioritized symptoms were consistent across focus group and survey participants and included the physical symptoms insomnia, fatigue, and cramping and the mood symptoms anxiety, depression, and frustration. Participants indicated that symptom frequency, duration, unpredictability, and social and financial effects factored most heavily into symptom prioritization. CONCLUSIONS:Patients prioritized the physical symptoms of insomnia, fatigue, and cramping and the mood symptoms of anxiety, depression, and frustration as the top symptoms for which to find new therapies.
Authors: S Susan Hedayati; Divya M Daniel; Scott Cohen; Bryan Comstock; Daniel Cukor; Yaminette Diaz-Linhart; Laura M Dember; Amelia Dubovsky; Tom Greene; Nancy Grote; Patrick Heagerty; Wayne Katon; Paul L Kimmel; Nancy Kutner; Lori Linke; Davin Quinn; Tessa Rue; Madhukar H Trivedi; Mark Unruh; Steven Weisbord; Bessie A Young; Rajnish Mehrotra Journal: Contemp Clin Trials Date: 2015-11-24 Impact factor: 2.226
Authors: M P Merkus; K J Jager; F W Dekker; R J de Haan; E W Boeschoten; R T Krediet Journal: Nephrol Dial Transplant Date: 1999-05 Impact factor: 5.992
Authors: S E Rosas; M Joffe; E Franklin; B L Strom; W Kotzker; C Brensinger; E Grossman; D Glasser; H I Feldman Journal: Kidney Int Date: 2001-06 Impact factor: 10.612
Authors: Rajiv Saran; Bruce Robinson; Kevin C Abbott; Lawrence Y C Agodoa; Patrick Albertus; John Ayanian; Rajesh Balkrishnan; Jennifer Bragg-Gresham; Jie Cao; Joline L T Chen; Elizabeth Cope; Sai Dharmarajan; Xue Dietrich; Ashley Eckard; Paul W Eggers; Charles Gaber; Daniel Gillen; Debbie Gipson; Haoyu Gu; Susan M Hailpern; Yoshio N Hall; Yun Han; Kevin He; Paul Hebert; Margaret Helmuth; William Herman; Michael Heung; David Hutton; Steven J Jacobsen; Nan Ji; Yan Jin; Kamyar Kalantar-Zadeh; Alissa Kapke; Ronit Katz; Csaba P Kovesdy; Vivian Kurtz; Danielle Lavalee; Yi Li; Yee Lu; Keith McCullough; Miklos Z Molnar; Maria Montez-Rath; Hal Morgenstern; Qiao Mu; Purna Mukhopadhyay; Brahmajee Nallamothu; Danh V Nguyen; Keith C Norris; Ann M O'Hare; Yoshitsugu Obi; Jeffrey Pearson; Ronald Pisoni; Brett Plattner; Friedrich K Port; Praveen Potukuchi; Panduranga Rao; Kaitlyn Ratkowiak; Vanessa Ravel; Debabrata Ray; Connie M Rhee; Douglas E Schaubel; David T Selewski; Sally Shaw; Jiaxiao Shi; Monica Shieu; John J Sim; Peter Song; Melissa Soohoo; Diane Steffick; Elani Streja; Manjula Kurella Tamura; Francesca Tentori; Anca Tilea; Lan Tong; Megan Turf; Dongyu Wang; Mia Wang; Kenneth Woodside; April Wyncott; Xin Xin; Wei Zang; Lindsay Zepel; Sai Zhang; Hui Zho; Richard A Hirth; Vahakn Shahinian Journal: Am J Kidney Dis Date: 2017-03 Impact factor: 8.860
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Authors: Steven D Weisbord; Maurizio Bossola; Linda F Fried; Stefania Giungi; Luigi Tazza; Paul M Palevsky; Robert M Arnold; Giovanna Luciani; Paul L Kimmel Journal: Hemodial Int Date: 2008-10 Impact factor: 1.812
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