TY - JOUR
T1 - Health-related quality of life among patients with comorbid diabetes and kidney disease attending a codesigned integrated model of care
T2 - A longitudinal study
AU - Zimbudzi, Edward
AU - Lo, Clement
AU - Ranasinha, Sanjeeva
AU - Teede, Helena
AU - Usherwood, Tim
AU - Polkinghorne, Kevan R.
AU - Fulcher, Greg
AU - Gallagher, Martin
AU - Jan, Steven
AU - Cass, Alan
AU - Walker, Rowan
AU - Russell, Grant
AU - Johnson, Greg
AU - Kerr, Peter G.
AU - Zoungas, Sophia
N1 - Funding This work was supported by a National Health and Medical Research Council, Australia (NHMRC) Partnership Grant (ID 1055175) between the following health services, research institutes and national consumer stakeholder groups: Alfred Health; Concord Hospital; Royal North Shore Hospital; Monash Health; Monash Centre for Health Research and Implementation, Monash University; The George Institute for Global Health, University of Sydney; Diabetes Australia; and Kidney Health Australia. An Australian Postgraduate Award Scholarship supported CL. HT was supported by an NHMRC, Practitioner Fellowship. An NHMRC Senior Research Fellowship supported SZ.
PY - 2020/1/6
Y1 - 2020/1/6
N2 - Objective: To 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 methods: A 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. Results: 179 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). Conclusion: The 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.
AB - Objective: To 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 methods: A 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. Results: 179 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). Conclusion: The 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.
KW - chronic kidney disease
KW - quality of Life
KW - type 2 diabetes
UR - http://www.scopus.com/inward/record.url?scp=85077742336&partnerID=8YFLogxK
U2 - 10.1136/bmjdrc-2019-000842
DO - 10.1136/bmjdrc-2019-000842
M3 - Article
C2 - 31958294
AN - SCOPUS:85077742336
VL - 8
JO - BMJ Open Diabetes Research and Care
JF - BMJ Open Diabetes Research and Care
SN - 2052-4897
IS - 1
M1 - e000842
ER -