Subjective Cognition is Related to Patient-Reported Symptom Distress and Work Productivity Among Liver Transplant Recipients

Abstract

Cognitive decline may prevent liver transplant (LT) recipients from staying healthy and independent. This study examined associations of objective and subjective, rated by LT recipients and caregivers, cognitive decline with patient-reported physical and psychological symptom distress, ability to perform household tasks, and workplace productivity among LT recipients. Sixty pairs of LT recipients and caregivers participated in this cross-sectional study. Subjective cognition was measured by the Everyday Cognition. Objective cognition was assessed with four cognitive tests, including the Repeatable Battery for the Assessment of Neuropsychological Status. Patient-reported outcomes were assessed with the Rotterdam Symptom Checklist-Modified, Profile of Mood States-Short Form, Creative Therapy Consultants Homemaking Assessment, and Work Limitations Questionnaire. Linear regression analyses related objective and subjective cognition to the patient-reported outcomes. While objective cognitive decline was not associated with any patient-reported outcomes, subjective cognitive decline was significantly associated with the outcomes. Higher LT recipient self-rated cognitive decline was associated with higher physical symptom distress (β = 0.30, p = 0.006) and workplace productivity loss (β = 14.85, p < 0.0001). Higher caregiver-rated cognitive decline was associated with lower household tasks performance (β = −18.55, p = 0.015). Findings suggest to consider subjective cognition when developing an individualized post-transplant care plan.

Review article: Telecare in gastroenterology—Within the COVID‐19 pandemic and beyond

“…Ko et al 62 Transpl Int, 2023 • Quantitative data was collected through an online survey during the pandemic. Qualitative data were collected through focus groups and individual interviews • Characteristics of telehealth non-users were not significantly different than telehealth users, except that telehealth users had higher levels of educational attainment compared to telehealth non-users Wegermann et al 61 Dig Dis Sci, 2022…”

The role of patient-reported outcomes in a patient-centered care model for managing chronic liver diseases

“…To this end, several studies have shown the acceptability of telemedicine for outpatient hepatology care. [29][30][31] PROs are categorized into generic and diseasespecific instruments. Generic instruments such as Patient-Reported Outcome Measurement Information System Profile 29 (PROMIS-29) (assessing 7 health domains-physical function, fatigue, social function, depression, anxiety, pain interference and social function, and pain intensity), Edmonton Symptom Assessment System (assessing symptom burden), Patient Health Questionnaire-9 (assessing depression) can be used clinically.…”

“…PROs can also guide PCC by identifying models of care acceptable to patients. To this end, several studies have shown the acceptability of telemedicine for outpatient hepatology care 29–31 …”