Health related quality of life of dialysis patients in Malaysia: Haemodialysis versus continuous ambulatory peritoneal dialysis

Surendra, Naren Kumar; Manaf, Mohd Rizal Abdul; Hooi, Lai Seong; Bavanandan, Sunita; Nor, Fariz Safhan Mohamad; Khan, Saad; Ong, Loke Meng; Gafor, Abdul Halim Abdul

doi:10.1186/s12882-019-1326-x

Cited by 27 publications

(34 citation statements)

References 47 publications

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“…The lesser LYs gained on CAPD was not compensated by a large increase in health utilities. Unlike in other countries utilities did not differ significantly in Malaysia [15]. In addition, the cost per QALY for both modalities exceeded RM40,000 which implies that both modalities are not highly cost-effective.…”

Section: 0 Discussionmentioning

confidence: 94%

“…a = Mean utility index for HD ( 0.854) and CAPD (0.905) [15]b = Mean cost per patient per year, RM39,791 for HD and RM37,576 for CAPD [14]…”

Section: 0 Resultsmentioning

confidence: 99%

“…The health utilities were collected during the last quarter of the study period. These results have been published [14, 15]. The secondary data for the survival analyses was sourced from the Malaysian Dialysis and Transplant Registry (MDTR).…”

Section: 0 Methodsmentioning

confidence: 99%

“…The descriptive system contains 5 health dimensions; mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. It can be transformed into an index score [15].…”

Section: 0 Methodsmentioning

confidence: 99%

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Cost utility analysis of end stage renal disease treatment in Ministry of Health dialysis centres, Malaysia: Hemodialysis versus continuous ambulatory peritoneal dialysis

et al. 2019

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ObjectivesIn Malaysia, there is exponential growth of patients on dialysis. Dialysis treatment consumes a considerable portion of healthcare expenditure. Comparative assessment of their cost effectiveness can assist in providing a rational basis for preference of dialysis modalities.MethodsA cost utility study of hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) was conducted from a Ministry of Health (MOH) perspective. A Markov model was also developed to investigate the cost effectiveness of increasing uptake of incident CAPD to 55% and 60% versus current practice of 40% CAPD in a five-year temporal horizon. A scenario with 30% CAPD was also measured. The costs and utilities were sourced from published data which were collected as part of this study. The transitional probabilities and survival estimates were obtained from the Malaysia Dialysis and Transplant Registry (MDTR). The outcome measures were cost per life year (LY), cost per quality adjusted LY (QALY) and incremental cost effectiveness ratio (ICER) for the Markov model. Sensitivity analyses were performed.ResultsLYs saved for HD was 4.15 years and 3.70 years for CAPD. QALYs saved for HD was 3.544 years and 3.348 for CAPD. Cost per LY saved was RM39,791 for HD and RM37,576 for CAPD. The cost per QALY gained was RM46,595 for HD and RM41,527 for CAPD. The Markov model showed commencement of CAPD in 50% of ESRD patients as initial dialysis modality was very cost-effective versus current practice of 40% within MOH. Reduction in CAPD use was associated with higher costs and a small devaluation in QALYs.ConclusionsThese findings suggest provision of both modalities is fiscally feasible; increasing CAPD as initial dialysis modality would be more cost-effective.

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Section: 0 Discussionmentioning

confidence: 94%

“…a = Mean utility index for HD ( 0.854) and CAPD (0.905) [15]b = Mean cost per patient per year, RM39,791 for HD and RM37,576 for CAPD [14]…”

Section: 0 Resultsmentioning

confidence: 99%

Section: 0 Methodsmentioning

confidence: 99%

“…The descriptive system contains 5 health dimensions; mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. It can be transformed into an index score [15].…”

Section: 0 Methodsmentioning

confidence: 99%

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Cost utility analysis of end stage renal disease treatment in Ministry of Health dialysis centres, Malaysia: Hemodialysis versus continuous ambulatory peritoneal dialysis

et al. 2019

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“…Of these, 152 studies were excluded leaving 68 studies for inclusion in the analysis. 2 , 3 , 5 , 7 , 8 , 14 , 19 , 24 - 84 The flow chart in Figure 1 outlines this process, including reasons for exclusion. Supplemental Table S1 provides a list of excluded studies wit...…”

Section: Resultsmentioning

confidence: 99%

The Prevalence and Severity of Chronic Pain in Patients With Chronic Kidney Disease: A Systematic Review and Meta-Analysis

Rathwell

Ghosh

George

et al. 2021

Can J Kidney Health Dis

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Background: Chronic pain is a common and distressing symptom reported by patients with chronic kidney disease (CKD). Clinical practice and research in this area do not appear to be advancing sufficiently to address the issue of chronic pain management in patients with CKD. Objectives: To determine the prevalence and severity of chronic pain in patients with CKD. Design: Systematic review and meta-analysis. Setting: Interventional and observational studies presenting data from 2000 or later. Exclusion criteria included acute kidney injury or studies that limited the study population to a specific cause, symptom, and/or comorbidity. Patients: Adults with glomerular filtration rate (GFR) category 3 to 5 CKD including dialysis patients and those managed conservatively without dialysis. Measurements: Data extracted included title, first author, design, country, year of data collection, publication year, mean age, stage of CKD, prevalence of pain, and severity of pain. Methods: Databases searched included MEDLINE, CINAHL, EMBASE, and Cochrane Library, last searched on February 3, 2020. Two reviewers independently screened all titles and abstracts, assessed potentially relevant articles, and extracted data. We estimated pooled prevalence of overall chronic pain, musculoskeletal pain, bone/joint pain, muscle pain/soreness, and neuropathic pain and the I2 statistic was computed to measure heterogeneity. Random effects models were used to account for variations in study design and sample populations and a double arcsine transformation was used in the model calculations to account for potential overweighting of studies reporting either very high or very low prevalence measurements. Pain severity scores were calibrated to a score out of 10, to compare across studies. Weighted mean severity scores and 95% confidence intervals were reported. Results: Sixty-eight studies representing 16 558 patients from 26 countries were included. The mean prevalence of chronic pain in hemodialysis patients was 60.5%, and the mean prevalence of moderate or severe pain was 43.6%. Although limited, pain prevalence data for peritoneal dialysis patients (35.9%), those managed conservatively without dialysis (59.8%), those following withdrawal of dialysis (39.2%), and patients with earlier GFR category of CKD (61.2%) suggest similarly high prevalence rates. Limitations: Studies lacked a consistent approach to defining the chronicity and nature of pain. There was also variability in the measures used to determine pain severity, limiting the ability to compare findings across populations. Furthermore, most studies reported mean severity scores for the entire cohort, rather than reporting the prevalence (numerator and denominator) for each of the pain severity categories (mild, moderate, and severe). Mean severity scores for a population do not allow for “responder analyses” nor allow for an understanding of clinically relevant pain. Conclusions: Chronic pain is common and often severe across diverse CKD populations providing a strong imperative to establish chronic pain management as a clinical and research priority. Future research needs to move toward a better understanding of the determinants of chronic pain and to evaluating the effectiveness of pain management strategies with particular attention to the patient outcomes such as overall symptom burden, physical function, and quality of life. The current variability in the outcome measures used to assess pain limits the ability to pool data or make comparisons among studies, which will hinder future evaluations of the efficacy and effectiveness of treatments. Recommendations for measuring and reporting pain in future CKD studies are provided. Trial registration: PROSPERO Registration number CRD42020166965

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Nephrology in Malaysia

Hooi¹,

Bavanandan

Ahmad

et al. 2021

Nephrology Worldwide

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Health related quality of life of dialysis patients in Malaysia: Haemodialysis versus continuous ambulatory peritoneal dialysis

Cited by 27 publications

References 47 publications

Cost utility analysis of end stage renal disease treatment in Ministry of Health dialysis centres, Malaysia: Hemodialysis versus continuous ambulatory peritoneal dialysis

Cost utility analysis of end stage renal disease treatment in Ministry of Health dialysis centres, Malaysia: Hemodialysis versus continuous ambulatory peritoneal dialysis

The Prevalence and Severity of Chronic Pain in Patients With Chronic Kidney Disease: A Systematic Review and Meta-Analysis

Nephrology in Malaysia

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