Frailty and the psychosocial components of the edmonton frail scale are most associated with patient experience in older kidney transplant candidates - a secondary analysis within the kidney transplantation in older people (KTOP) study.

Autor:	Thind AK; Centre for Inflammatory Disease, Department of Immunology and Inflammation, Imperial College London, London, United Kingdom.; Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom., Levy S; Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom., Wellsted D; The Centre for Health Services and Clinical Research, The University of Hertfordshire, Hertfordshire, United Kingdom., Willicombe M; Centre for Inflammatory Disease, Department of Immunology and Inflammation, Imperial College London, London, United Kingdom.; Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom., Brown EA; Centre for Inflammatory Disease, Department of Immunology and Inflammation, Imperial College London, London, United Kingdom.; Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom.
Jazyk:	angličtina
Zdroj:	Frontiers in nephrology [Front Nephrol] 2023 Jan 17; Vol. 2, pp. 1058765. Date of Electronic Publication: 2023 Jan 17 (Print Publication: 2022).
DOI:	10.3389/fneph.2022.1058765
Abstrakt:	Background: Older people with end-stage kidney disease (ESKD) are vulnerable to frailty, which impacts on clinical and experiential outcomes. With kidney transplantation in older people increasing, a better understanding of patient experiences is necessary for guiding decision making. The Kidney Transplantation in Older People (KTOP):impact of frailty on outcomes study aims to explore this. We present a secondary analysis of the Edmonton Frail Scale (EFS) and its relationship with patient experience scores. Methods: The KTOP study is a single centre, prospective study, which began in October 2019. All ESKD patients aged ≥60 considered for transplantation at Imperial College Renal and Transplant Centre were eligible. Frailty was assessed using the EFS and 5 questionnaires assessed patient experience and quality of life (QoL) (Short Form-12(v2), Palliative Care Outcome Scale-Symptoms Renal, Depression Patient Health Questionnaire-9, Illness Intrusiveness Ratings Scale, Renal Treatment Satisfaction Questionnaire). The EFS was divided into 4 subdomains (psychosocial, physical function, medical status, and general health) and then compared with the questionnaire scores. Results: 210 patients have been recruited (aged 60-78), 186 of whom completed EFS assessments. 118 (63.4%) participants were not frail, 36 (19.4%) vulnerable, and 32 (17.2%) were frail. Worse frailty scores were associated with poorer patient experience and QoL scores across all questionnaires. Severe deficits in the EFS psychosocial subdomain showed a statistically significant association with higher depression screen scores (coefficient 4.9, 95% CI 3.22 to 6.59), lower physical (coefficient -4.35, 95% CI -7.59 to -1.12) and mental function scores (coefficient -8.33, 95% CI -11.77 to -4.88) from the Short Form-12(v2), and lower renal treatment satisfaction scores (coefficient -5.54, 95% CI -10.70 to -0.37). Deficits in the physical function and medical status EFS subdomians showed some association with patient experience scores. Conclusion: In the KTOP study cohort at recruitment vulnerable and frail candidates reported worse QoL and patient experiences. Severe deficits in the psychosocial subdomains of the EFS showed a strong association with patient experience and QoL, whilst physical function and medical status deficits showed a lesser association. This has highlighted specific EFS domains that may be suitable for targeted interventions to improve experiences and optimise outcomes. Competing Interests: EB – Baxter Healthcare: speaker fees and advisory board; AWAK – advisory board; liberDi – advisory board. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be constructed as a potential conflict of interest. (Copyright © 2023 Thind, Levy, Wellsted, Willicombe and Brown.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu