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

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  • Additional Information
    • Source:
      Publisher: Published by BMJ in partnership with the American Diabetes Association Country of Publication: England NLM ID: 101641391 Publication Model: Print Cited Medium: Internet ISSN: 2052-4897 (Electronic) Linking ISSN: 20524897 NLM ISO Abbreviation: BMJ Open Diabetes Res Care Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : Published by BMJ in partnership with the American Diabetes Association
    • Subject Terms:
      Quality of Life*; Delivery of Health Care, Integrated/*organization & administration ; Diabetes Mellitus/*epidemiology ; Quality of Health Care/*standards ; Renal Insufficiency, Chronic/*epidemiology; Aged ; Australia/epidemiology ; Comorbidity ; Delivery of Health Care, Integrated/methods ; Female ; Follow-Up Studies ; Humans ; Incidence ; Longitudinal Studies ; Male ; Prognosis ; Surveys and Questionnaires
    • 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.
      Competing Interests: Competing interests: None declared.
      (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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    • Contributed Indexing:
      Keywords: chronic kidney disease; quality of Life; type 2 diabetes
    • Publication Date:
      Date Created: 20200121 Date Completed: 20200929 Latest Revision: 20200929
    • Publication Date:
      20221213
    • Accession Number:
      PMC6954749
    • Accession Number:
      10.1136/bmjdrc-2019-000842
    • Accession Number:
      31958294