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Effectiveness and safety profiling of zolpidem and acupressure in CKD associated pruritus: An interventional study

BACKGROUND: Chronic kidney disease (CKD)-associated pruritus (CKD-aP) contributes to poor quality of life, including reduced sleep quality and poor sleep quality is a source of patient stress and is linked to lower health-related quality of life. This study aimed to investigate the effectiveness of...

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Autores principales: Rehman, Inayat Ur, Ahmed, Raheel, Rahman, Aziz Ur, Wu, David Bin Chia, Munib, Syed, Shah, Yasar, Khan, Nisar Ahmad, Rehman, Ateeq Ur, Lee, Learn Han, Chan, Kok Gan, Khan, Tahir Mehmood
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8154401/
https://www.ncbi.nlm.nih.gov/pubmed/34032717
http://dx.doi.org/10.1097/MD.0000000000025995
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author Rehman, Inayat Ur
Ahmed, Raheel
Rahman, Aziz Ur
Wu, David Bin Chia
Munib, Syed
Shah, Yasar
Khan, Nisar Ahmad
Rehman, Ateeq Ur
Lee, Learn Han
Chan, Kok Gan
Khan, Tahir Mehmood
author_facet Rehman, Inayat Ur
Ahmed, Raheel
Rahman, Aziz Ur
Wu, David Bin Chia
Munib, Syed
Shah, Yasar
Khan, Nisar Ahmad
Rehman, Ateeq Ur
Lee, Learn Han
Chan, Kok Gan
Khan, Tahir Mehmood
author_sort Rehman, Inayat Ur
collection PubMed
description BACKGROUND: Chronic kidney disease (CKD)-associated pruritus (CKD-aP) contributes to poor quality of life, including reduced sleep quality and poor sleep quality is a source of patient stress and is linked to lower health-related quality of life. This study aimed to investigate the effectiveness of zolpidem 10 mg and acupressure therapy on foot acupoints to improve the sleep quality and overall quality of life among hemodialysis patients suffering from CKD-aP. METHOD: A multicenter, prospective, randomized, parallel-design, open label interventional study to estimate the effectiveness of zolpidem (10 mg) oral tablets versus acupressure on sleep quality and quality of life in patients with CKD-aP on hemodialysis. A total of 58 hemodialysis patients having sleep disturbance due to CKD-aP completed the entire 8-week follow-up. The patients were divided into a control (acupressure) group of 28 patients and an intervention (zolpidem) group of 30 patients. RESULTS: A total of 58 patients having CKD-aP and sleep disturbance were recruited. In the control group there was a reduction in the PSQI score with a mean ± SD from 12.28 ± 3.59 to 9.25 ± 3.99, while in the intervention group the reduction in PSQI score with a mean ± SD was from 14.73 ± 4.14 to 10.03 ± 4.04 from baseline to endpoint. However, the EQ5D index score and EQ-visual analogue scale (VAS) at baseline for the control group with a mean ± SD was 0.49 ± 0.30 and 50.17 ± 8.65, respectively, while for the intervention group the values were 0.62 ± 0.26 and 47.17 ± 5.82, respectively. The mean EQ5D index score in the control group improved from 0.49 ± 0.30 to 0.53 ± 0.30, but in the intervention group there was no statistical improvement in mean EQ5D index score from 0.62 ± 0.26 to 0.62 ± 0.27 from baseline to week 8. The EQ 5D improved in both groups and the EQ-VAS score was 2.67 points higher at week 8 as compared to baseline in the control group, while in the intervention group the score was 3.33 points higher at week 8 as compared to baseline. Comparing with baseline, the PSQI scores were significantly reduced after week 4 and week 8 (P =  < .001). Furthermore, at the end of the study, the PSQI scores were significantly higher in the control as compared to the intervention group (P = .012). CONCLUSION: An improvement in sleep quality and quality of life among CKD-aP patients on hemodialysis has been observed in both the control and intervention groups. Zolpidem and acupressure safety profiling showed no severe adverse effect other that drowsiness, nausea and daytime sleeping already reported in literature of zolpidem.
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spelling pubmed-81544012021-05-29 Effectiveness and safety profiling of zolpidem and acupressure in CKD associated pruritus: An interventional study Rehman, Inayat Ur Ahmed, Raheel Rahman, Aziz Ur Wu, David Bin Chia Munib, Syed Shah, Yasar Khan, Nisar Ahmad Rehman, Ateeq Ur Lee, Learn Han Chan, Kok Gan Khan, Tahir Mehmood Medicine (Baltimore) 5200 BACKGROUND: Chronic kidney disease (CKD)-associated pruritus (CKD-aP) contributes to poor quality of life, including reduced sleep quality and poor sleep quality is a source of patient stress and is linked to lower health-related quality of life. This study aimed to investigate the effectiveness of zolpidem 10 mg and acupressure therapy on foot acupoints to improve the sleep quality and overall quality of life among hemodialysis patients suffering from CKD-aP. METHOD: A multicenter, prospective, randomized, parallel-design, open label interventional study to estimate the effectiveness of zolpidem (10 mg) oral tablets versus acupressure on sleep quality and quality of life in patients with CKD-aP on hemodialysis. A total of 58 hemodialysis patients having sleep disturbance due to CKD-aP completed the entire 8-week follow-up. The patients were divided into a control (acupressure) group of 28 patients and an intervention (zolpidem) group of 30 patients. RESULTS: A total of 58 patients having CKD-aP and sleep disturbance were recruited. In the control group there was a reduction in the PSQI score with a mean ± SD from 12.28 ± 3.59 to 9.25 ± 3.99, while in the intervention group the reduction in PSQI score with a mean ± SD was from 14.73 ± 4.14 to 10.03 ± 4.04 from baseline to endpoint. However, the EQ5D index score and EQ-visual analogue scale (VAS) at baseline for the control group with a mean ± SD was 0.49 ± 0.30 and 50.17 ± 8.65, respectively, while for the intervention group the values were 0.62 ± 0.26 and 47.17 ± 5.82, respectively. The mean EQ5D index score in the control group improved from 0.49 ± 0.30 to 0.53 ± 0.30, but in the intervention group there was no statistical improvement in mean EQ5D index score from 0.62 ± 0.26 to 0.62 ± 0.27 from baseline to week 8. The EQ 5D improved in both groups and the EQ-VAS score was 2.67 points higher at week 8 as compared to baseline in the control group, while in the intervention group the score was 3.33 points higher at week 8 as compared to baseline. Comparing with baseline, the PSQI scores were significantly reduced after week 4 and week 8 (P =  < .001). Furthermore, at the end of the study, the PSQI scores were significantly higher in the control as compared to the intervention group (P = .012). CONCLUSION: An improvement in sleep quality and quality of life among CKD-aP patients on hemodialysis has been observed in both the control and intervention groups. Zolpidem and acupressure safety profiling showed no severe adverse effect other that drowsiness, nausea and daytime sleeping already reported in literature of zolpidem. Lippincott Williams & Wilkins 2021-05-28 /pmc/articles/PMC8154401/ /pubmed/34032717 http://dx.doi.org/10.1097/MD.0000000000025995 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/)
spellingShingle 5200
Rehman, Inayat Ur
Ahmed, Raheel
Rahman, Aziz Ur
Wu, David Bin Chia
Munib, Syed
Shah, Yasar
Khan, Nisar Ahmad
Rehman, Ateeq Ur
Lee, Learn Han
Chan, Kok Gan
Khan, Tahir Mehmood
Effectiveness and safety profiling of zolpidem and acupressure in CKD associated pruritus: An interventional study
title Effectiveness and safety profiling of zolpidem and acupressure in CKD associated pruritus: An interventional study
title_full Effectiveness and safety profiling of zolpidem and acupressure in CKD associated pruritus: An interventional study
title_fullStr Effectiveness and safety profiling of zolpidem and acupressure in CKD associated pruritus: An interventional study
title_full_unstemmed Effectiveness and safety profiling of zolpidem and acupressure in CKD associated pruritus: An interventional study
title_short Effectiveness and safety profiling of zolpidem and acupressure in CKD associated pruritus: An interventional study
title_sort effectiveness and safety profiling of zolpidem and acupressure in ckd associated pruritus: an interventional study
topic 5200
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8154401/
https://www.ncbi.nlm.nih.gov/pubmed/34032717
http://dx.doi.org/10.1097/MD.0000000000025995
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