Changes in quality of life over time--Dutch haemodialysis patients and general population compared

Mazairac, Albert H.A.; Wit, G. Ardine de; Penne, E. Lars; Weerd, Neelke C. van der; Jong, B. de; Grooteman, Muriël P.C.; Dorpel, Marinus A. van den; Buskens, Erik; Dekker, Friedo W.; Nubé, Menso J.; Wee, Piet M. ter; Boeschoten, Els W.; Bots, Michiel L.

doi:10.1093/ndt/gfq680

Cited by 33 publications

(43 citation statements)

References 29 publications

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“…[1][2][3] Poorer health-related quality of life (HRQOL) is associated with increase in morbidity and mortality among patients. 4,5 Previous studies reported that HRQOL depends on treatment modality.…”

Section: Introductionmentioning

confidence: 99%

Influence of Dialysis Modality and Membrane Flux on Quality of Life in Hemodialysis Patients

Knežević¹,

Djordjević²,

Radovanovic-Velickovic³

et al. 2012

Renal Failure

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Background: The quality of life in patients undergoing hemodialysis is significantly disturbed. There are data that hemodiafiltration (HDF) may be more effective than conventional hemodialysis in the removal of uremic toxins and may reduce frequency and severity of intradialytic and postdialysis adverse symptoms in patients. Also, some researchers suggest advantages of using high-flux membranes compared with low-flux. Objective: The aim of this study was to examine whether hemodialysis modality and membrane flux, independent of membrane biocompatibility, make differences in quality of life in patients. Methods: In our cross-sectional study, we evaluated 124 patients who were divided, based on therapy, into three groups: online HDF, high-flux hemodialysis, and low-flux hemodialysis. Data were collected using the Short Form-36 questionnaire combined with special questionnaire, which included demographic and clinically related questions. Results: Health-related quality of life was better in patients on HDF compared with patients on hemodialysis, especially compared with low-flux hemodialysis patients in most of the scales and in both dimensions: physical component scale and mental component scale. There were no statistically significant differences in Short Form-36 domains between high-flux hemodialysis and low-flux hemodialysis. Conclusion: Our data suggest the potential advantages of HDF with regard to influence on quality of life, which is sufficient to justify further research in prospective and longitudinal study design.

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Section: Introductionmentioning

confidence: 99%

Influence of Dialysis Modality and Membrane Flux on Quality of Life in Hemodialysis Patients

Knežević¹,

Djordjević²,

Radovanovic-Velickovic³

et al. 2012

Renal Failure

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“…Quality of life is a patient-important quality measure of care that often matters more to patients on dialysis than survival (3,9,(14)(15)(16). Researchers have found that patientreported quality of life is inversely proportional to the number of troublesome symptoms that patients report, such as pain (17,18), and treatment of symptoms improves patient quality of life (19,20).…”

Section: Problems With Current and Proposed Esrd Qip Measuresmentioning

confidence: 99%

“…A key goal for nephrology clinicians is to provide optimal patient care to maximize patient quality of life (9). However, patient perception of quality of life is multifactorial and composed of objective and subjective physical, emotional, and social aspects (10).…”

mentioning

confidence: 99%

“…However, patient perception of quality of life is multifactorial and composed of objective and subjective physical, emotional, and social aspects (10). Sadly, numerous studies suggest that the quality of life of patients with ESRD is below that of general age-, race-, and sexmatched populations (4,9,10). Disease-oriented approaches to improve patient quality of life, such as more intense and frequent hemodialysis, which have had disease-related benefits like reducing left ventricular mass and hypertension, have not had a major effect on the quality of life of patients on dialysis (11,12).…”

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confidence: 99%

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How the ESRD Quality Incentive Program Could Potentially Improve Quality of Life for Patients on Dialysis

Moss

Davison

2015

Clinical Journal of the American Society of Nephrology

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For over 20 years, the quality of medical care of the Medicare ESRD Program has been a concern. The Centers for Medicare and Medicaid Services have implemented the ESRD Quality Incentive Program, which uses the principles of value-based purchasing; dialysis providers are paid for performance on predefined quality measures, with a goal of improving patient outcomes and the quality of patient care. The ESRD Quality Incentive Program measures have been criticized, because they are largely disease oriented and use easy-to-obtain laboratory-based indicators, such as Kt/V and hemoglobin, that do not reflect outcomes that are most important to patients and have had a minimal effect on survival or quality of life. A key goal of improving quality of care is to enhance quality of life, a patient-important quality measure that matters more to many patients than even survival. None of the ESRD Quality Incentive Program measures assess patient-reported quality of life. As outlined in the National Quality Strategy, the Centers for Medicare and Medicaid Services are holding providers accountable in six priority domains, in which quality measures have been and are being developed for value-based purchasing. Three measures-patient experience and engagement, clinical care, and care coordination-are particularly relevant to quality care in the ESRD Program; the 2014 ESRD Quality Incentive Program includes six measures, none of which provide data from a patient-centered perspective. Valuebased purchasing is a well intentioned step to improve care of patients on dialysis. However, the Centers for Medicare and Medicaid Services need to implement significant change in what is measured for the ESRD Quality Incentive Program to be patient centered and aligned with patients' values, preferences, and needs. This paper provides examples of potential quality measures for patient experience and engagement, clinical care, and care coordination, which if implemented, would be much more likely to enhance quality of life for patients with ESRD than present ESRD Quality Incentive Program measures.Clin J Am Soc Nephrol 10: 888-893, 2015. doi: 10.2215/CJN.07410714 Concerns about Quality Care and Patient Quality of Life in the ESRD ProgramFor over 20 years, nephrologists and other researchers studying the Medicare ESRD Program have been concerned about the quality of medical care and the quality of life of patients on dialysis (1-4). The Centers for Medicare and Medicaid Services (CMS) have implemented value-based purchasing to improve quality in patient care (5). The CMS calls the ESRD Quality Incentive Program (QIP) their most recent step in fostering improved patient outcomes by establishing incentives for dialysis facilities to meet or exceed performance standards that the CMS has established (6). The ESRD QIP measures have been criticized, because they are disease oriented (7) and use easy-to-obtain laboratory-based indicators, such as Kt/V and hemoglobin, that do not reflect outcomes that are important to patients and that have had a m...

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“…Chronic kidney disease and renal replacement therapies (RRTs) can cause significant changes in patients' lives and can substantially reduce QoL compared with a general population. 4 QoL can be worse in these patients than in patients with cancer 5 and is worse in patients beginning HD therapy than in those receiving established long-term HD. 6 HD can provoke negative influence on QoL, because these patients have to deal with the symptoms; follow a special diet program; and reconsider their personal, social, and professional objectives.…”

Section: Introductionmentioning

confidence: 97%

Can Dialysis Modality Influence Quality of Life in Chronic Hemodialysis Patients? Low-Flux Hemodialysis versus High-Flux Hemodiafiltration: A Cross-Over Study

et al. 2012

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Background: Hemodiafiltration with online preparation of the substitution [online high-flux hemodiafiltration (OHDF)] and hemodiafiltration with prepared bags of substitution (HDF) are important, recently widely used renal replacement therapies in patients with end-stage renal disease. However, there is little information on the comparative impacts of these modalities versus conventional low-flux hemodialysis (HD) on the quality of life (QoL) of HD patients. This study investigates the effect of dialysis modality on QoL in chronic HD patients. Methods: In this prospective, randomized, cross-over, open label study, 24 patients were enrolled. Their age were 62 AE 13.34 years (mean AE SD), with the duration of dialysis of 31 AE 23.28 months (mean AE SD). Five of the patients were women. QoL was measured by the Short-Form Health Survey with 36 questions (SF-36) and subscale scores were calculated. Each patient received HD, OHDF, and HDF for 3 months, with the dialysis modality subsequently being altered. They completed the questionnaire of QoL at the end of each period. Results: There were statistical significant differences in QoL for the total .7) and 40.7 (30.2-62.8)], for classic low-flux HD and high-flux hemodiafiltration, for bodily pain [45 (26.9-66.9) and 55 (35.6-87.5)], and for role limitations due to emotional functioning [0 (0-33.3) and 33.3 (0-100)], respectively. The scores did not differ significantly between the two types of hemodiafiltration. Conclusions: Our study indicates that QoL differs significantly among patients receiving low-flux HD and high-flux hemodiafiltration, on total SF-36, bodily pain, and role limitations due to emotional functioning. Convective modalities may offer better QoL than diffusive HD.

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Changes in quality of life over time--Dutch haemodialysis patients and general population compared

Abstract: This study showed an improvement of HRQOL in haemodialysis patients over an 11-year period of time, independent of global changes in the general population.

Cited by 33 publications

References 29 publications

Influence of Dialysis Modality and Membrane Flux on Quality of Life in Hemodialysis Patients

Influence of Dialysis Modality and Membrane Flux on Quality of Life in Hemodialysis Patients

How the ESRD Quality Incentive Program Could Potentially Improve Quality of Life for Patients on Dialysis

Can Dialysis Modality Influence Quality of Life in Chronic Hemodialysis Patients? Low-Flux Hemodialysis versus High-Flux Hemodiafiltration: A Cross-Over Study

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