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Symptom burden according to dialysis day of the week in three times a week haemodialysis patients

BACKGROUND: Haemodialysis patients experience significant symptom burden and effects on health-related quality of life. Studies have shown increases in fluid overload, hospitalization and mortality immediately after the long interdialytic interval in thrice weekly in-centre haemodialysis patients, h...

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Autores principales: Hnynn Si, Pann Ei, Gair, Rachel, Barnes, Tania, Dunn, Louese, Lee, Sonia, Ariss, Steven, Walters, Stephen J., Wilkie, Martin, Fotheringham, James
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9514641/
https://www.ncbi.nlm.nih.gov/pubmed/36166424
http://dx.doi.org/10.1371/journal.pone.0274599
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author Hnynn Si, Pann Ei
Gair, Rachel
Barnes, Tania
Dunn, Louese
Lee, Sonia
Ariss, Steven
Walters, Stephen J.
Wilkie, Martin
Fotheringham, James
author_facet Hnynn Si, Pann Ei
Gair, Rachel
Barnes, Tania
Dunn, Louese
Lee, Sonia
Ariss, Steven
Walters, Stephen J.
Wilkie, Martin
Fotheringham, James
author_sort Hnynn Si, Pann Ei
collection PubMed
description BACKGROUND: Haemodialysis patients experience significant symptom burden and effects on health-related quality of life. Studies have shown increases in fluid overload, hospitalization and mortality immediately after the long interdialytic interval in thrice weekly in-centre haemodialysis patients, however the relationship between the dialytic interval and patient reported outcome measures (PROMs) has not been quantified and the extent to which dialysis day of PROM completion needs to be standardised is unknown. METHODS: Three times a week haemodialysis patients participating in a stepped wedge trial to increase patient participation in haemodialysis tasks completed PROMs (POS-S Renal symptom score and EQ-5D-5L) at recruitment, six, 12 and 18 months. Time from the long interdialytic interval, HD day of the week, and HD days vs non-HD days were included in mixed effects Linear Regression, estimating severity (none to overwhelming treated as 0 to 4) of 17 symptoms and EQ-5D-5L, adjusting for age, sex, time on HD, control versus intervention and Charlson Comorbidity Score. RESULTS: 517 patients completed 1659 YHS questionnaires that could be assigned HD day (510 on Mon/Tue/Sun, 549 on Wed/Thu/Tue, 308 on Fri/Sat/Thu and 269 on non-HD days). With the exception of restless legs and skin changes, there was no statistically significant change in symptom severity or EQ-5D-5L with increasing time from the long interdialytic interval. Patients who responded on non-HD days had higher severity of poor appetite, constipation, difficulty sleeping, poor mobility and depression (approximately 0.2 severity level), and lower EQ-5D-5L (-0.06, CI -0.09 to -0.03) compared to HD days. CONCLUSIONS: Measuring symptom severity and EQ-5D-5L in haemodialysis populations does not need to account for dialysis schedule, but completion either on HD or non-HD days could introduce bias that may impact evaluation of interventions. Researchers should ensure completion of these instruments are standardized on either dialysis or non-dialysis days.
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spelling pubmed-95146412022-09-28 Symptom burden according to dialysis day of the week in three times a week haemodialysis patients Hnynn Si, Pann Ei Gair, Rachel Barnes, Tania Dunn, Louese Lee, Sonia Ariss, Steven Walters, Stephen J. Wilkie, Martin Fotheringham, James PLoS One Research Article BACKGROUND: Haemodialysis patients experience significant symptom burden and effects on health-related quality of life. Studies have shown increases in fluid overload, hospitalization and mortality immediately after the long interdialytic interval in thrice weekly in-centre haemodialysis patients, however the relationship between the dialytic interval and patient reported outcome measures (PROMs) has not been quantified and the extent to which dialysis day of PROM completion needs to be standardised is unknown. METHODS: Three times a week haemodialysis patients participating in a stepped wedge trial to increase patient participation in haemodialysis tasks completed PROMs (POS-S Renal symptom score and EQ-5D-5L) at recruitment, six, 12 and 18 months. Time from the long interdialytic interval, HD day of the week, and HD days vs non-HD days were included in mixed effects Linear Regression, estimating severity (none to overwhelming treated as 0 to 4) of 17 symptoms and EQ-5D-5L, adjusting for age, sex, time on HD, control versus intervention and Charlson Comorbidity Score. RESULTS: 517 patients completed 1659 YHS questionnaires that could be assigned HD day (510 on Mon/Tue/Sun, 549 on Wed/Thu/Tue, 308 on Fri/Sat/Thu and 269 on non-HD days). With the exception of restless legs and skin changes, there was no statistically significant change in symptom severity or EQ-5D-5L with increasing time from the long interdialytic interval. Patients who responded on non-HD days had higher severity of poor appetite, constipation, difficulty sleeping, poor mobility and depression (approximately 0.2 severity level), and lower EQ-5D-5L (-0.06, CI -0.09 to -0.03) compared to HD days. CONCLUSIONS: Measuring symptom severity and EQ-5D-5L in haemodialysis populations does not need to account for dialysis schedule, but completion either on HD or non-HD days could introduce bias that may impact evaluation of interventions. Researchers should ensure completion of these instruments are standardized on either dialysis or non-dialysis days. Public Library of Science 2022-09-27 /pmc/articles/PMC9514641/ /pubmed/36166424 http://dx.doi.org/10.1371/journal.pone.0274599 Text en © 2022 Hnynn Si et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Hnynn Si, Pann Ei
Gair, Rachel
Barnes, Tania
Dunn, Louese
Lee, Sonia
Ariss, Steven
Walters, Stephen J.
Wilkie, Martin
Fotheringham, James
Symptom burden according to dialysis day of the week in three times a week haemodialysis patients
title Symptom burden according to dialysis day of the week in three times a week haemodialysis patients
title_full Symptom burden according to dialysis day of the week in three times a week haemodialysis patients
title_fullStr Symptom burden according to dialysis day of the week in three times a week haemodialysis patients
title_full_unstemmed Symptom burden according to dialysis day of the week in three times a week haemodialysis patients
title_short Symptom burden according to dialysis day of the week in three times a week haemodialysis patients
title_sort symptom burden according to dialysis day of the week in three times a week haemodialysis patients
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9514641/
https://www.ncbi.nlm.nih.gov/pubmed/36166424
http://dx.doi.org/10.1371/journal.pone.0274599
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