Understanding What Influences the Health-Related Quality of Life of Hemodialysis Patients: A Collaborative Study in England and Ireland

Aoife C Lowney; Helena T Myles; Katherine Bristowe; Eanna L Lowney; Katie Shepherd; Marie Murphy; Tony O'Brien; Liam Casserly; Regina McQuillan; William D Plant; Peter J Conlon; Catherine Vinen; Joseph A Eustace; Felicity E M Murtagh

doi:10.1016/j.jpainsymman.2015.07.010

Understanding What Influences the Health-Related Quality of Life of Hemodialysis Patients: A Collaborative Study in England and Ireland

Aoife C Lowney, Helena T Myles, Katherine Bristowe, Eanna L Lowney, Katie Shepherd, Marie Murphy, Tony O'Brien, Liam Casserly, Regina McQuillan, William D Plant, Peter J Conlon, Catherine Vinen, Joseph A Eustace, Felicity E M Murtagh

Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation

Research output: Contribution to journal › Article › peer-review

51 Citations (Scopus)

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 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 to population norms. Specifically, 64% of patients reported pain (95% CI: 61-67%) and 79% reported weakness (95% CI: 75-81%). A total of forty-three percent of patients reported between six and ten 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 waitlist 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.

Original language	English
Pages (from-to)	778–785
Number of pages	8
Journal	Journal of pain and symptom management
Volume	50
Issue number	6
DOIs	https://doi.org/10.1016/j.jpainsymman.2015.07.010
Publication status	Published - Dec 2015

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10.1016/j.jpainsymman.2015.07.010

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Lowney, A. C., Myles, H. T., Bristowe, K., Lowney, E. L., Shepherd, K., Murphy, M., O'Brien, T., Casserly, L., McQuillan, R., Plant, W. D., Conlon, P. J., Vinen, C., Eustace, J. A., & Murtagh, F. E. M. (2015). Understanding What Influences the Health-Related Quality of Life of Hemodialysis Patients: A Collaborative Study in England and Ireland. Journal of pain and symptom management, 50(6), 778–785. https://doi.org/10.1016/j.jpainsymman.2015.07.010

@article{796c7edee1794c5e8e8968b29b4c421e,

title = "Understanding What Influences the Health-Related Quality of Life of Hemodialysis Patients: A Collaborative Study in England and 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 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 to population norms. Specifically, 64% of patients reported pain (95% CI: 61-67%) and 79% reported weakness (95% CI: 75-81%). A total of forty-three percent of patients reported between six and ten 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 waitlist 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.",

author = "Lowney, {Aoife C} and Myles, {Helena T} and Katherine Bristowe and Lowney, {Eanna L} and Katie Shepherd and Marie Murphy and Tony O'Brien and Liam Casserly and Regina McQuillan and Plant, {William D} and Conlon, {Peter J} and Catherine Vinen and Eustace, {Joseph A} and Murtagh, {Felicity E M}",

year = "2015",

month = dec,

doi = "10.1016/j.jpainsymman.2015.07.010",

language = "English",

volume = "50",

pages = "778–785",

journal = "Journal of pain and symptom management",

issn = "0885-3924",

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Lowney, AC, Myles, HT, Bristowe, K, Lowney, EL, Shepherd, K, Murphy, M, O'Brien, T, Casserly, L, McQuillan, R, Plant, WD, Conlon, PJ, Vinen, C, Eustace, JA & Murtagh, FEM 2015, 'Understanding What Influences the Health-Related Quality of Life of Hemodialysis Patients: A Collaborative Study in England and Ireland', Journal of pain and symptom management, vol. 50, no. 6, pp. 778–785. https://doi.org/10.1016/j.jpainsymman.2015.07.010

TY - JOUR

T1 - Understanding What Influences the Health-Related Quality of Life of Hemodialysis Patients

T2 - A Collaborative Study in England and Ireland

AU - Lowney, Aoife C

AU - Myles, Helena T

AU - Bristowe, Katherine

AU - Lowney, Eanna L

AU - Shepherd, Katie

AU - Murphy, Marie

AU - O'Brien, Tony

AU - Casserly, Liam

AU - McQuillan, Regina

AU - Plant, William D

AU - Conlon, Peter J

AU - Vinen, Catherine

AU - Eustace, Joseph A

AU - Murtagh, Felicity E M

PY - 2015/12

Y1 - 2015/12

N2 - 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 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 to population norms. Specifically, 64% of patients reported pain (95% CI: 61-67%) and 79% reported weakness (95% CI: 75-81%). A total of forty-three percent of patients reported between six and ten 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 waitlist 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.

AB - 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 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 to population norms. Specifically, 64% of patients reported pain (95% CI: 61-67%) and 79% reported weakness (95% CI: 75-81%). A total of forty-three percent of patients reported between six and ten 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 waitlist 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.

U2 - 10.1016/j.jpainsymman.2015.07.010

DO - 10.1016/j.jpainsymman.2015.07.010

M3 - Article

C2 - 26300026

SN - 0885-3924

VL - 50

SP - 778

EP - 785

JO - Journal of pain and symptom management

JF - Journal of pain and symptom management

IS - 6

ER -

Understanding What Influences the Health-Related Quality of Life of Hemodialysis Patients: A Collaborative Study in England and Ireland

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