Could symptom burden predict subsequent healthcare use in patients with end stage kidney disease on hemodialysis care? A prospective, preliminary study

Renal Failure

Marta Novak¹  Mark L. Lipman²  Joyce Wu³  Ghizlane Moussaoui³  Salam El-Majzoub³  Karl J. Looper³  Soham Rej³  Tibyan Ahmed⁴  Jing C. Zhang⁴  Istvan Mucsi⁴  Madeline Li⁵ 

[1] Centre for Mental Health, University Health Network;Department of Nephrology, Jewish General Hospital;Geri-PARTy Research Group, Department of Psychiatry, Jewish General Hospital, Lady-Davis Institute for Medical Research, McGill University;Multi-Organ Transplant Program and Division of Nephrology, University Health Network, University of Toronto;Princess Margaret Cancer Centre, University Health Network;

关键词: maintenance hemodialysis;    edmonton symptom assessment system-revised;    end-stage kidney disease;    healthcare use;   

DOI  :  10.1080/0886022X.2020.1744449

来源: DOAJ

【 摘 要 】

Context Patients treated with maintenance hemodialysis experience significant symptom burden resulting in impaired quality of life. However, the association of patient reported symptom burden and the risk of healthcare use for patients with end stage kidney disease on hemodialysis has not been fully explored. Objectives To investigate if higher symptom burden, assessed by the Edmonton Symptom Assessment System-revised (ESASr), is associated with increased healthcare use in patients with end stage kidney disease on hemodialysis. Methods Prospective, single-center, study of adult patients on HD. Participants completed the ESASr questionnaire at enrollment. Baseline demographic, clinical information as well as healthcare use events during the 12-month following enrollment were extracted from medical records. The association between symptom burden and healthcare use was examined with a multivariable adjusted negative binomial model. Results Mean (SD) age of the 80 participants was 71 (13) years, 56% diabetic, and 70% male. The median (IQR) dialysis vintage was 2 (1–4) years. In multivariable adjusted models, higher global [incident rate ratio (IRR) 1.02, 95% confidence interval (CI) 1.00–1.04, p = .025] and physical symptom burden score [IRR 1.03, CI 1.00–1.05, p = .034], but not emotional symptom burden score [IRR 1.05, CI 1.00–1.10, p = .052] predicted higher subsequent healthcare use. Conclusions Our preliminary evidence suggests that higher symptom burden, assessed by ESASr may predict higher risk of healthcare use amongst patients with end stage kidney disease on hemodialysis. Future studies need to confirm the findings of this preliminary study and to assess the utility of ESASr for systematic symptom screening.

【 授权许可】

Unknown