Quality of Life in Caregivers of Patients Randomized to Standard- Versus Extended-Hours Hemodialysis

Melissa Nataatmadja; Rathika Krishnasamy; Li Zuo; Daqing Hong; Brendan Smyth; Min Jun; Janak R. de Zoysa; Kirsten Howard; Jing Wang; Chunlai Lu; Zhangsuo Liu; Christopher T. Chan; Alan Cass; Vlado Perkovic; Meg Jardine; Nicholas A. Gray

doi:10.1016/j.ekir.2021.01.020

Quality of Life in Caregivers of Patients Randomized to Standard- Versus Extended-Hours Hemodialysis

Melissa Nataatmadja, Rathika Krishnasamy, Li Zuo, Daqing Hong, Brendan Smyth, Min Jun, Janak R. de Zoysa, Kirsten Howard, Jing Wang, Chunlai Lu, Zhangsuo Liu, Christopher T. Chan, Alan Cass, Vlado Perkovic, Meg Jardine, Nicholas A. Gray

Menzies School of Health Research

Research output: Contribution to journal › Article › peer-review

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Abstract

Introduction
Caregivers are essential for the health, safety, and independence of many patients and incur financial and personal cost in this role, including increased burden and lower quality of life (QOL) compared to the general population. Extended-hours hemodialysis may be the preference of some patients, but little is known about its effects on caregivers.

Methods
Forty caregivers of participants of the ACTIVE Dialysis trial, who were randomized to 12 months extended (median 24 hours/wk) or standard (12 hours/wk) hemodialysis, were included. Utility-based QOL was measured by EuroQOL–5 Dimension–3 Level (EQ-5D-3L) and Short Form–6 Dimensions (SF-6D) and health-related QOL (HRQOL) was measured by the 36-Item Short Form Health Survey (SF-36) physical component summary (PCS) and mental component summary (MCS) and the Personal Wellbeing Index (PWI) at enrolment and then every 3 months until the end of the study.

Results
At baseline, utility-based QOL and HRQOL were similar in both groups. At follow-up, caregivers of people randomized to extended-hours dialysis experienced a greater decrease in utility-based QOL measured by EQ-5D-3L compared with caregivers of people randomized to standard hours (–0.18±0.30 vs. –0.02±0.16, P = 0.04). There were no differences between extended- and standard-hours groups in mean change in SF-6D (0.03±0.12 vs. –0.04±0.1, P = 0.8), PCS (–1.2±9.8 vs. –5.6±9.8, P = 0.2), MCS (–4.1±11.2 vs. –0.5±7.1, P = 0.4), and PWI (2.3±17.6 vs. 0.00±20.4, P = 0.9).

Conclusion
Poorer utility-based QOL, as measured by the EQ-5D-3L, was observed in caregivers of patients receiving extended-hours hemodialysis in this small study. Though the findings are exploratory, the possibility that mode of dialysis delivery negatively impacts on caregivers supports the prioritization of research on burden and impact of service delivery in this population.

Original language	English
Pages (from-to)	1058-1065
Number of pages	8
Journal	Kidney International Reports
Volume	6
Issue number	4
DOIs	https://doi.org/10.1016/j.ekir.2021.01.020
Publication status	Published - Apr 2021

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10.1016/j.ekir.2021.01.020

41477106-oaFinal published version, 830 KBLicence: CC BY-NC-ND

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Nataatmadja, M., Krishnasamy, R., Zuo, L., Hong, D., Smyth, B., Jun, M., de Zoysa, J. R., Howard, K., Wang, J., Lu, C., Liu, Z., Chan, C. T., Cass, A., Perkovic, V., Jardine, M., & Gray, N. A. (2021). Quality of Life in Caregivers of Patients Randomized to Standard- Versus Extended-Hours Hemodialysis. Kidney International Reports, 6(4), 1058-1065. https://doi.org/10.1016/j.ekir.2021.01.020

@article{0ca27428501d49a1842e4139ec3e97b1,

title = "Quality of Life in Caregivers of Patients Randomized to Standard- Versus Extended-Hours Hemodialysis",

abstract = "IntroductionCaregivers are essential for the health, safety, and independence of many patients and incur financial and personal cost in this role, including increased burden and lower quality of life (QOL) compared to the general population. Extended-hours hemodialysis may be the preference of some patients, but little is known about its effects on caregivers.MethodsForty caregivers of participants of the ACTIVE Dialysis trial, who were randomized to 12 months extended (median 24 hours/wk) or standard (12 hours/wk) hemodialysis, were included. Utility-based QOL was measured by EuroQOL–5 Dimension–3 Level (EQ-5D-3L) and Short Form–6 Dimensions (SF-6D) and health-related QOL (HRQOL) was measured by the 36-Item Short Form Health Survey (SF-36) physical component summary (PCS) and mental component summary (MCS) and the Personal Wellbeing Index (PWI) at enrolment and then every 3 months until the end of the study.ResultsAt baseline, utility-based QOL and HRQOL were similar in both groups. At follow-up, caregivers of people randomized to extended-hours dialysis experienced a greater decrease in utility-based QOL measured by EQ-5D-3L compared with caregivers of people randomized to standard hours (–0.18±0.30 vs. –0.02±0.16, P = 0.04). There were no differences between extended- and standard-hours groups in mean change in SF-6D (0.03±0.12 vs. –0.04±0.1, P = 0.8), PCS (–1.2±9.8 vs. –5.6±9.8, P = 0.2), MCS (–4.1±11.2 vs. –0.5±7.1, P = 0.4), and PWI (2.3±17.6 vs. 0.00±20.4, P = 0.9).ConclusionPoorer utility-based QOL, as measured by the EQ-5D-3L, was observed in caregivers of patients receiving extended-hours hemodialysis in this small study. Though the findings are exploratory, the possibility that mode of dialysis delivery negatively impacts on caregivers supports the prioritization of research on burden and impact of service delivery in this population.",

keywords = "caregiver, Co-ACTIVE, extended dialysis, hemodialysis, quality of life",

author = "Melissa Nataatmadja and Rathika Krishnasamy and Li Zuo and Daqing Hong and Brendan Smyth and Min Jun and {de Zoysa}, {Janak R.} and Kirsten Howard and Jing Wang and Chunlai Lu and Zhangsuo Liu and Chan, {Christopher T.} and Alan Cass and Vlado Perkovic and Meg Jardine and Gray, {Nicholas A.}",

note = "Funding Information: Funding for Co-ACTIVE provided through grants from the Private Practice Trust Fund of the Sunshine Coast Hospital and Health Service. The ACTIVE Dialysis trial was supported by a National Health and Medical Research Council (NHMRC) of Australia project grant (571045) and a Baxter Clinical Evidence Council Investigator Initiated research grant (2012), with additional support from an unrestricted grant from Baxter International Inc. with funding for the vanguard phase from an NHMRC program grant (358395). The funders had no role in study design; collection, analysis, and interpretation of data; writing the report; and the decision to submit the report for publication. We are grateful to the investigators and study personnel, and especially the participants, involved in both ACTIVE and Co-ACTIVE, whose contributions have made this research possible. Study inception and design: NG, KH, LZ, JdZ, AC, VP, MeJ. Data collection: LZ, DH, MiJ, BS, JW, CL, ZL. Data analysis and interpretation: MN, RK, NG, BS, KH, MeJ. Manuscript preparation: MN, NG, RK. Revision and approval of final manuscript: all authors Publisher Copyright: {\textcopyright} 2021 International Society of Nephrology",

year = "2021",

month = apr,

doi = "10.1016/j.ekir.2021.01.020",

language = "English",

volume = "6",

pages = "1058--1065",

journal = "Kidney International Reports",

issn = "2468-0249",

publisher = "Elsevier",

number = "4",

}

Nataatmadja, M, Krishnasamy, R, Zuo, L, Hong, D, Smyth, B, Jun, M, de Zoysa, JR, Howard, K, Wang, J, Lu, C, Liu, Z, Chan, CT, Cass, A, Perkovic, V, Jardine, M & Gray, NA 2021, 'Quality of Life in Caregivers of Patients Randomized to Standard- Versus Extended-Hours Hemodialysis', Kidney International Reports, vol. 6, no. 4, pp. 1058-1065. https://doi.org/10.1016/j.ekir.2021.01.020

TY - JOUR

T1 - Quality of Life in Caregivers of Patients Randomized to Standard- Versus Extended-Hours Hemodialysis

AU - Nataatmadja, Melissa

AU - Krishnasamy, Rathika

AU - Zuo, Li

AU - Hong, Daqing

AU - Smyth, Brendan

AU - Jun, Min

AU - de Zoysa, Janak R.

AU - Howard, Kirsten

AU - Wang, Jing

AU - Lu, Chunlai

AU - Liu, Zhangsuo

AU - Chan, Christopher T.

AU - Cass, Alan

AU - Perkovic, Vlado

AU - Jardine, Meg

AU - Gray, Nicholas A.

N1 - Funding Information: Funding for Co-ACTIVE provided through grants from the Private Practice Trust Fund of the Sunshine Coast Hospital and Health Service. The ACTIVE Dialysis trial was supported by a National Health and Medical Research Council (NHMRC) of Australia project grant (571045) and a Baxter Clinical Evidence Council Investigator Initiated research grant (2012), with additional support from an unrestricted grant from Baxter International Inc. with funding for the vanguard phase from an NHMRC program grant (358395). The funders had no role in study design; collection, analysis, and interpretation of data; writing the report; and the decision to submit the report for publication. We are grateful to the investigators and study personnel, and especially the participants, involved in both ACTIVE and Co-ACTIVE, whose contributions have made this research possible. Study inception and design: NG, KH, LZ, JdZ, AC, VP, MeJ. Data collection: LZ, DH, MiJ, BS, JW, CL, ZL. Data analysis and interpretation: MN, RK, NG, BS, KH, MeJ. Manuscript preparation: MN, NG, RK. Revision and approval of final manuscript: all authors Publisher Copyright: © 2021 International Society of Nephrology

PY - 2021/4

Y1 - 2021/4

N2 - IntroductionCaregivers are essential for the health, safety, and independence of many patients and incur financial and personal cost in this role, including increased burden and lower quality of life (QOL) compared to the general population. Extended-hours hemodialysis may be the preference of some patients, but little is known about its effects on caregivers.MethodsForty caregivers of participants of the ACTIVE Dialysis trial, who were randomized to 12 months extended (median 24 hours/wk) or standard (12 hours/wk) hemodialysis, were included. Utility-based QOL was measured by EuroQOL–5 Dimension–3 Level (EQ-5D-3L) and Short Form–6 Dimensions (SF-6D) and health-related QOL (HRQOL) was measured by the 36-Item Short Form Health Survey (SF-36) physical component summary (PCS) and mental component summary (MCS) and the Personal Wellbeing Index (PWI) at enrolment and then every 3 months until the end of the study.ResultsAt baseline, utility-based QOL and HRQOL were similar in both groups. At follow-up, caregivers of people randomized to extended-hours dialysis experienced a greater decrease in utility-based QOL measured by EQ-5D-3L compared with caregivers of people randomized to standard hours (–0.18±0.30 vs. –0.02±0.16, P = 0.04). There were no differences between extended- and standard-hours groups in mean change in SF-6D (0.03±0.12 vs. –0.04±0.1, P = 0.8), PCS (–1.2±9.8 vs. –5.6±9.8, P = 0.2), MCS (–4.1±11.2 vs. –0.5±7.1, P = 0.4), and PWI (2.3±17.6 vs. 0.00±20.4, P = 0.9).ConclusionPoorer utility-based QOL, as measured by the EQ-5D-3L, was observed in caregivers of patients receiving extended-hours hemodialysis in this small study. Though the findings are exploratory, the possibility that mode of dialysis delivery negatively impacts on caregivers supports the prioritization of research on burden and impact of service delivery in this population.

AB - IntroductionCaregivers are essential for the health, safety, and independence of many patients and incur financial and personal cost in this role, including increased burden and lower quality of life (QOL) compared to the general population. Extended-hours hemodialysis may be the preference of some patients, but little is known about its effects on caregivers.MethodsForty caregivers of participants of the ACTIVE Dialysis trial, who were randomized to 12 months extended (median 24 hours/wk) or standard (12 hours/wk) hemodialysis, were included. Utility-based QOL was measured by EuroQOL–5 Dimension–3 Level (EQ-5D-3L) and Short Form–6 Dimensions (SF-6D) and health-related QOL (HRQOL) was measured by the 36-Item Short Form Health Survey (SF-36) physical component summary (PCS) and mental component summary (MCS) and the Personal Wellbeing Index (PWI) at enrolment and then every 3 months until the end of the study.ResultsAt baseline, utility-based QOL and HRQOL were similar in both groups. At follow-up, caregivers of people randomized to extended-hours dialysis experienced a greater decrease in utility-based QOL measured by EQ-5D-3L compared with caregivers of people randomized to standard hours (–0.18±0.30 vs. –0.02±0.16, P = 0.04). There were no differences between extended- and standard-hours groups in mean change in SF-6D (0.03±0.12 vs. –0.04±0.1, P = 0.8), PCS (–1.2±9.8 vs. –5.6±9.8, P = 0.2), MCS (–4.1±11.2 vs. –0.5±7.1, P = 0.4), and PWI (2.3±17.6 vs. 0.00±20.4, P = 0.9).ConclusionPoorer utility-based QOL, as measured by the EQ-5D-3L, was observed in caregivers of patients receiving extended-hours hemodialysis in this small study. Though the findings are exploratory, the possibility that mode of dialysis delivery negatively impacts on caregivers supports the prioritization of research on burden and impact of service delivery in this population.

KW - caregiver

KW - Co-ACTIVE

KW - extended dialysis

KW - hemodialysis

KW - quality of life

UR - http://www.scopus.com/inward/record.url?scp=85103414829&partnerID=8YFLogxK

U2 - 10.1016/j.ekir.2021.01.020

DO - 10.1016/j.ekir.2021.01.020

M3 - Article

C2 - 33912756

AN - SCOPUS:85103414829

SN - 2468-0249

VL - 6

SP - 1058

EP - 1065

JO - Kidney International Reports

JF - Kidney International Reports

IS - 4

ER -

Quality of Life in Caregivers of Patients Randomized to Standard- Versus Extended-Hours Hemodialysis

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