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Could symptom burden predict subsequent healthcare use in patients with end stage kidney disease on hemodialysis care? A prospective, preliminary study
- Source :
- Renal Failure, Vol 42, Iss 1, Pp 294-301 (2020), Renal Failure
- Publication Year :
- 2020
- Publisher :
- Informa UK Limited, 2020.
-
Abstract
- 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.
- Subjects :
- Male
medicine.medical_specialty
Healthcare use
030232 urology & nephrology
Context (language use)
030204 cardiovascular system & hematology
lcsh:RC870-923
Critical Care and Intensive Care Medicine
Health Services Accessibility
Hemodialysis care
03 medical and health sciences
0302 clinical medicine
Quality of life (healthcare)
Renal Dialysis
end-stage kidney disease
Humans
Medicine
edmonton symptom assessment system-revised
In patient
Prospective Studies
Intensive care medicine
End-stage kidney disease
Aged
Aged, 80 and over
business.industry
Symptom burden
healthcare use
General Medicine
Maintenance hemodialysis
Middle Aged
lcsh:Diseases of the genitourinary system. Urology
Symptom Flare Up
maintenance hemodialysis
Nephrology
Clinical Study
Quality of Life
Kidney Failure, Chronic
Female
business
Delivery of Health Care
Subjects
Details
- ISSN :
- 15256049 and 0886022X
- Volume :
- 42
- Database :
- OpenAIRE
- Journal :
- Renal Failure
- Accession number :
- edsair.doi.dedup.....092a51ccefdbecac15fdf2617309d843