COMPARISON OF PATIENT SYMPTOM BURDEN BY DIALYSIS MODALITY – A SINGLE CENTRE ANALYSIS
Dr Lee Skeat1,2, MS Sharonne Hennessy1
1Royal Hobart Hospital, Hobart, Australia, 2University of Tasmania, Hobart, Australia
Aim: To understand patient symptom burden across renal replacement therapy (RRT) modalities in a single centre in Southern Tasmania.
Background: Renal patients often experience a high symptom burden. This occurs across modalities including peritoneal dialysis, haemodialysis and conservative care pathways. Renal Supportive Care (RSC) services can assist with symptom management and improve quality of life, however within the local service, resources are limited. Establishing priority groups for RSC is essential in delivering patient care.
Methods: A retrospective review was undertaken of the integrated palliative care outcome scale (IPOS) scores of all patients on home haemodialysis (HHD), in centre haemodialysis (ICH), Peritoneal Dialysis (PD) & conservative care pathways (CCP). The average IPOS score over a 12-month period in 2022 were reviewed by modality.
Results: A total of 127 patients were included, HHD (3), IHD (81), PD (11) and CCP (37). Symptom burden was high across modalities with slight or moderate symptom scores in virtually all patient modalities across the board. Severe symptoms were reported more frequently in the renal supportive care group compared to all dialysis modalities. Most significant severe symptom burden included diarrhoea (11% in RSC group versus 3% (IHD), Reduced mobility (16% vs 0% in other groups) and poor sleep (11% in RSC versus 7% in IHD and 0% in other groups).
Conclusion: Symptom burden in this patient cohort is high regardless of modality, however the renal supportive care cohorts have a higher symptom burden than other groups. Interestingly the more severe symptoms were not necessarily those traditionally associated with kidney disease, including diarrhoea, reduced mobility and sleep disturbance. This analysis highlights the importance of RSC services being tailored towards the local patient cohort.
Biography:
Lee Skeat is a nephrologist based in Hobart with an interest in renal supportive care.