Health-related quality of life among patients with comorbid diabetes and kidney disease attending a codesigned integrated model of care: a longitudinal study

Abstract

ObjectiveTo evaluate the impact of an integrated diabetes and kidney disease model of care on health-related quality of life (HRQOL) of patients with comorbid diabetes and chronic kidney disease (CKD).Research design and methodsA longitudinal study of adult patients (over 18 years) with comorbid diabetes and CKD (stage 3a or worse) who attended a new diabetes kidney disease service was conducted at a tertiary hospital. A questionnaire consisting of demographics, clinical data, and the Kidney Disease Quality of Life (KDQOL-36) was administered at baseline and after 12 months. Paired t-tests were used to compare baseline and 12-month scores. A subgroup analysis examined the effects by patient gender. Multiple regression analysis examined the factors associated with changes in scores.Results179 patients, 36% of whom were female, with baseline mean±SD age of 65.9±11.3 years, were studied. Across all subscales, HRQOL did not significantly change over time (p value for all mean differences >0.05). However, on subgroup analysis, symptom problem list and physical composite summary scores increased among women (MD=9.0, 95% CI 1.25 to 16.67; p=0.02 and MD=4.5, 95% CI 0.57 to 8.42; p=0.03 respectively) and physical composite scores decreased among men (MD=−3.35, 95% CI −6.26 to −0.44; p=0.03).ConclusionThe HRQOL of patients with comorbid diabetes and CKD attending a new codesigned, integrated diabetes and kidney disease model of care was maintained over 12 months. Given that HRQOL is known to deteriorate over time in this high-risk population, the impact of these findings on clinical outcomes warrants further investigation.

Alterations in symptoms and health‐related quality of life as kidney function deteriorates: A cross‐sectional study

“…This finding emphasises a negative relationship between symptoms and HRQoL across the CKD trajectory. The participants of this study were, however, relatively younger (by a decade) and had fewer comorbidities when compared to people with CKD from other countries (see for example Nguyen et al, 2017; Zimbudzi et al, 2020). Nevertheless, substantial symptom burden and impaired HRQoL were experienced even at this younger age.…”

Health-Related Quality of Life In T1DM Patients After High-Dose Cholecalciferol Supplementation.

“…Studies have shown that, among patients with CKD, HRQoL gradually declines as the disease progresses, with the worst HRQoL scores obtained when an advanced stage of kidney disease is reached (34,35).…”

Qualidade de vida em indivíduos diabéticos em terapia renal substitutiva: revisão sistemática

“…Assim, independentemente de apresentar duas condições crônicas, os indivíduos dos estudos consideraram que a sua qualidade de vida é boa nos domínios referentes a doença renal (Gumprecht et al, 2010;Marte et al, 2019;Sorensen et al, 2007). Este resultado pode estar relacionado ao fato que os indivíduos aceitam melhor o diagnóstico e a modalidade de tratamento, aprenderam a conviver com as patologias, recebem mais atenção da equipe médica e de enfermagem, e consequentemente formam vínculos afetivos com a equipe (Zimbudzi et al, 2020).…”

“…Nessa perspectiva, vale dizer que a qualidade vida é um indicador do impacto de uma condição de saúde na vida e no bem-estar de uma pessoa e permite identificar os fatores que podem ser melhorados (Zimbudzi et al, 2020). Atualmente, é um dos principais objetivos da medicina moderna, em especial quando se refere aos pacientes com doença renal crônica e diabetes mellitus que recebem tratamento de longo prazo e cuidados para suas condições progressivas e complexas (Zazzeroni et al, 2017).…”