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

Edward Zimbudzi, Clement Lo, Sanjeeva Ranasinha, Helena Teede, Tim Usherwood, Kevan R. Polkinghorne, Greg Fulcher, Martin Gallagher, Steven Jan, Alan Cass, Rowan Walker, Grant Russell, Greg Johnson, Peter G. Kerr, Sophia Zoungas

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    Abstract

    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.

    Original languageEnglish
    Article numbere000842
    JournalBMJ Open Diabetes Research and Care
    Volume8
    Issue number1
    DOIs
    Publication statusPublished - 6 Jan 2020

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