Health‐related quality of life is maintained in hemodialysis patients receiving pharmaceutical care: A 2‐year randomized, controlled study

Abstract

End-stage renal disease and initiation of hemodialysis (HD) adversely affect health-related quality of life (HRQOL). There are currently no data evaluating the effect of pharmaceutical care (PC) on HRQOL in HD patients. HD patients were randomized to receive PC; one-on-one, in-depth medication reviews conducted by a clinical pharmacist or Standard of Care (SOC); and brief medication reviews conducted by dialysis nurses. The renal quality of life profile (RQLP) was administered at baseline and then at 1 and 2 years after study initiation. The RQLP is a 43-item questionnaire that has 5 dimensions: Eating/Drinking, Physical Activities, Leisure Time, Psychosocial Activities, and Impact of Treatment, where increasing scores reflect worsening of HRQOL. A total of 107 patients were enrolled (SOC: n=46; PC: n=61). Besides gender, there were no differences in the demographics or the baseline total RQLP scores. The mean+/-SD total RQLP scores at Year 1 were significantly worse in SOC compared with PC (88+/-31 vs. 71+/-34, respectively; P=0.03). Significant worsening of Eating and Drinking (5.9+/-3.3 vs. 4.4+/-3.1, respectively; P=0.04), Physical Activities (37+/-13.6 vs. 30+/-16.3, respectively; P=0.04), and Leisure Time scores (8.3+/-3.4 vs. 5.9+/-3.6, respectively; P=0.03) was also observed in the SOC group. After 2 years, only the SOC patients had worsening of Leisure Time (7.5+/-3.0 vs. 5.2+/-3.9, respectively; P=0.04). No other parameters were different between the groups after 2 years. These data indicate that patients who have clinical care provided by pharmacists do not have worsened HRQOL after 1 year and are able to maintain HRQOL for an additional year.

Impact of Pharmacists’ Counseling on Quality of Life in Patients Undergoing Hemodialysis in a Tertiary Care Teaching Hospital

“…In the current study, evaluation of the difference between the group with respect to each domain using independent sample "t" test, it is found that there was a significant improvement in the mean domain score in the intervention group for all the four domains as compared to the group that was not provided with an intervention. This observation is in agreement with similar results obtained at other centers using a variety of QoL questioners [15][16][17][18][19][20]. A significant mean score difference (P < 0.01) is indicative that pharmacists' counseling has an impact on improving the QoL in hemodialysis patients.…”

Clinical pharmacy activities in chronic kidney disease and end-stage renal disease patients: a systematic literature review

“…The interventions performed in the included studies could be roughly grouped into the following categories: (1) general clinical pharmacy services (n = 12, 57.1%) [12-23], (2) clinical pharmacy services focusing on disease management (n = 7, 33.3%) [24-30] and (3) clinical pharmacy services with a focus on educational activities (n = 2, 9.5%) [31,32]. A listing of reported clinical pharmacist activities is provided in Table 4.…”

“…In 47.6% (n = 10) of the included studies [13,16,24-31], disease-oriented outcomes were reported, whereas patient-oriented outcome data were only available in four studies (19%) [22,23,31,32]. A synthesis of the disease- and patient-oriented outcome data is shown in Table 5.…”

“…Information on the drug classes among which the clinical pharmacists detected the majority of DRPs was reported in four of 10 studies [12,19,22,23]. The most commonly affected drugs were those used for treatment against renal bone disease and renal osteodystrophy together with anaemia and cardiovascular drugs.…”

Factores asociados a la calidad de vida de pacientes con enfermedad cardiovascular en un programa de seguimiento Farmacoterapéutico

“…Otro aspecto importante a tener en cuenta es la polimedicación y la presencia de eventos y acontecimientos adversos relacionados con los medicamentos cuyo impacto también puede verse reflejado en la calidad de vida de pacientes con enfermedades crónicas [5] que presentan complicaciones que demandan un consumo alto de medicamentos. Estos problemas pueden ser detectados mediante el seguimiento farmacoterapéutico que además de ser una intervención efectiva en el control clínico, contribuye a mejorar la calidad de vida relacionada con la salud en los pacientes con hipertensión arterial esencial [6], diabetes mellitus [7] e insuficiencia renal crónica [8].…”