EQ-5D in dialysis units: a PROM with a view

Authors

  • Inês Sala Department of Nephrology, Hospital de Santo António (HSA), Centro Hospitalar do Porto (CHUPorto), 4099-001 Porto, Portugal https://orcid.org/0000-0003-3316-221X
  • Anabela Rodrigues 1 Department of Nephrology, Hospital de Santo António (HSA), Centro Hospitalar do Porto (CHUPorto), 4099-001 Porto, Portugal 2 UMIB - Unit for Multidisciplinary Research in Biomedicine, ICBAS - School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal. 3 ITR - Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal https://orcid.org/0000-0001-8818-2141

DOI:

https://doi.org/10.25796/bdd.v4i4.69733

Keywords:

Q-5D, quality of life, dialysis, PROM

Abstract

Summary

Chronic kidney disease (CKD) is a silent worldwide epidemic responsible for a high clinical and socioeconomic burden. Beyond disease-related outcomes, there is an urgent need for clinicians to focus on implementation of validated patient-reported outcome measures (PROMs) in routine care practice. This updated concept of high-quality renal care implies a changing paradigm, with a focus on patient experiences and health-related quality of life (HRQL) measures. This is even more crucial in end-stage renal disease, where adequate dialysis should aim at a multidimensional approach instead of only analytical targets. It is vital to emphasize interventions that positively affect the quality of life of the patient with CKD beyond improving their survival. Although the importance of using HRQL measures is well established, there has been resistance to their use in routine care. There are numerous tools to assess HRQL, but not all are easy to apply. It is essential to overcome these possible barriers and better adequate the HRQL tools to the patients. The shorter and simpler instruments are more appealing, as well as the electronic health questionnaires. The EuroQol-5 Dimensions tool (EQ5D) is a standardized measure of health status, is simple and quick, and provides information that can be used in economic assessments of healthcare.
In this era of limited health resources, cost analysis and economic evaluations are becoming increasingly relevant. In dialysis units, sustainability management should include a pathway of integrated care, including home and center dialysis, that values the better adjustment of prescriptions to the individual patient. The authors advocate using the EQ5D to support this pathway of quality in dialysis units toward global health gains. The EQ5D is a PROM with a view centered on patient and sustainable health services.

References

Johansen KL, Chertow GM, Gilbertson DT, Herzog CA, Ishani A, Israni AK, et al. US Renal Data System 2021 Annual Data Report: Epidemiology of Kidney Disease in the United States. Am J Kidney Dis. 2022;79(4 Suppl 1):A8-a12.

Alliance EKH. Tackling Chronic Kidney Disease at European level. 2022.

de Almeida EAF, Raimundo M, Coelho A, Sá H. Incidence, prevalence and crude survival of patients starting dialysis in Portugal (2010-16): analysis of the National Health System individual registry. Clin Kidney J. 2021;14(3):869-75.

Stel VS, de Jong RW, Kramer A, Andrusev AM, Baltar JM, Barbullushi M, et al. Supplemented ERA-EDTA Registry data evaluated the frequency of dialysis, kidney transplantation, and comprehensive conservative management for patients with kidney failure in Europe. Kidney Int. 2021;100(1):182-95.

Renal replacement therapy services for adults.

Fletcher BR, Damery S, Aiyegbusi OL, Anderson N, Calvert M, Cockwell P, et al. Symptom burden and health-related quality of life in chronic kidney disease: A global systematic review and meta-analysis. PLoS Med. 2022;19(4):e1003954.

Manera KE, Johnson DW, Craig JC, Shen JI, Ruiz L, Wang AY, et al. Patient and Caregiver Priorities for Outcomes in Peritoneal Dialysis: Multinational Nominal Group Technique Study. Clin J Am Soc Nephrol. 2019;14(1):74-83.

Guerraoui A, Prezelin-Reydit M, Kolko A, Lino-Daniel M, de Roque CD, Urena P, et al. Patient-reported outcome measures in hemodialysis patients: results of the first multicenter cross-sectional ePROMs study in France. BMC Nephrol. 2021;22(1):357.

Ayav C, Couchoud C, Sautenet B, Lobbedez T, Sens F, Moranne O. Le recueil en routine de données de santé perçue à l’ère du paiement à la qualité : préconisations de la Commission épidémiologie et santé publique de la SFNDT. Néphrologie & Thérapeutique. 2020;16(7):401-7.

Gloanec M, Capuano F, Sainte-Croix D, May-Michelangeli L. [Not Available]. Soins. 2018;63(829):23-6.

Mapes DL, Lopes AA, Satayathum S, McCullough KP, Goodkin DA, Locatelli F, et al. Health-related quality of life as a predictor of mortality and hospitalization: the Dialysis Outcomes and Practice Patterns Study (DOPPS). Kidney Int. 2003;64(1):339-49.

Oh TR, Choi HS, Kim CS, Bae EH, Oh YK, Kim Y-S, et al. Association between health related quality of life and progression of chronic kidney disease. Scientific Reports. 2019;9(1):19595.

Hamilton AJ, Caskey FJ, Casula A, Ben-Shlomo Y, Inward CD. Psychosocial Health and Lifestyle Behaviors in Young Adults Receiving Renal Replacement Therapy Compared to the General Population: Findings From the SPEAK Study. Am J Kidney Dis. 2019;73(2):194-205.

Hays RD, Kallich JD, Mapes DL, Coons SJ, Carter WB. Development of the kidney disease quality of life (KDQOL) instrument. Qual Life Res. 1994;3(5):329-38.

Peipert JD, Bentler PM, Klicko K, Hays RD. Psychometric Properties of the Kidney Disease Quality of Life 36-Item Short-Form Survey (KDQOL-36) in the United States. Am J Kidney Dis. 2018;71(4):461-8.

Wyld M, Morton RL, Hayen A, Howard K, Webster AC. A systematic review and meta-analysis of utility-based quality of life in chronic kidney disease treatments. PLoS Med. 2012;9(9):e1001307.

Gonçalves FA, Dalosso IF, Borba JM, Bucaneve J, Valerio NM, Okamoto CT, et al. Quality of life in chronic renal patients on hemodialysis or peritoneal dialysis: a comparative study in a referral service of Curitiba - PR. J Bras Nefrol. 2015;37(4):467-74.

Iyasere OU, Brown EA, Johansson L, Huson L, Smee J, Maxwell AP, et al. Quality of Life and Physical Function in Older Patients on Dialysis: A Comparison of Assisted Peritoneal Dialysis with Hemodialysis. Clin J Am Soc Nephrol. 2016;11(3):423-30

de Abreu MM, Walker DR, Sesso RC, Ferraz MB. Health-related quality of life of patients recieving hemodialysis and peritoneal dialysis in São Paulo, Brazil: a longitudinal study. Value Health. 2011;14(5 Suppl 1):S119-21.

Chuasuwan A, Pooripussarakul S, Thakkinstian A, Ingsathit A, Pattanaprateep O. Comparisons of quality of life between patients underwent peritoneal dialysis and hemodialysis: a systematic review and meta-analysis. Health and Quality of Life Outcomes. 2020;18(1):191.

Chang YT, Hwang JS, Hung SY, Tsai MS, Wu JL, Sung JM, et al. Cost-effectiveness of hemodialysis and peritoneal dialysis: A national cohort study with 14 years follow-up and matched for comorbidities and propensity score. Sci Rep. 2016;6:30266.

Karnofsky DA, Burchenal JH. In: Evaluation of chemotherapeutic agents. MacLeod CM, editor. New York: Columbia University Press; 1949. The clinical evaluation of chemotherapeutic agents in cancer; pp. 191–205.

UserGuide EE-D-L. 2019.

Hays RD, Kallich JD, Mapes DL, Coons SJ, Carter WB. Development of the kidney disease quality of life (KDQOL) instrument. Qual Life Res. 1994;3(5):329–338.

Peipert JD, Bentler PM, Klicko K, Hays RD. Psychometric Properties of the Kidney Disease Quality of Life 36‐Item Short‐Form Survey (KDQOL‐36) in the United States. Am J Kidney Dis. 2018;71(4):461–468.

Laupacis A, Muirhead N, Keown P, Wong C. A disease‐specific questionnaire for assessing quality of life in patients on hemodialysis. Nephron. 1992;60(3):302–306.

Wasserfallen JB, Halabi G, Saudan P, Perneger T, Feldman HI, Martin PY, et al. Quality of life on chronic dialysis: comparison between haemodialysis and peritoneal dialysis. Nephrol Dial Transplant. 2004;19(6):1594-9.

Kang GW, Lee IH, Ahn KS, Lee J, Ji Y, Woo J. Clinical and psychosocial factors predicting health-related quality of life in hemodialysis patients. Hemodial Int. 2015;19(3):439-46.

Yang F, Lau T, Lee E, Vathsala A, Chia KS, Luo N. Comparison of the preference-based EQ-5D-5L and SF-6D in patients with end-stage renal disease (ESRD). Eur J Health Econ. 2015;16(9):1019-26.

Zyoud SH, Daraghmeh DN, Mezyed DO, Khdeir RL, Sawafta MN, Ayaseh NA, et al. Factors affecting quality of life in patients on haemodialysis: a cross-sectional study from Palestine. BMC Nephrol. 2016;17(1):44.

Eddama O, Coast J. A systematic review of the use of economic evaluation in local decision-making. Health Policy. (2008) 86:129–41. doi: 10.1016/j.healthpol.2007.11.010

Richardson G, Manca A. Calculation of quality adjusted life years in the published literature: a review of methodology and transparency. Health Econ 2004;13:1203–10.

Ferreira, Lara de Noronha - Utilidades, QALYs e medição da qualidade de vida = utilities, QALYs and measurement of health related quality of life. Revista Portuguesa de Saúde Pública. ISSN 0870-9025. Volume temático, Nº 3 (2003), p. 51-63

Dolan P. Modeling valuations for EuroQol health states. Med Care. 1997;35(11):1095-108.

Brazier J, Roberts J, Deverill M. The estimation of a preference-based measure of health from the SF-36. J Health Econ. 2002;21(2):271-92.

Viramontes-Hörner D, Pittman Z, Selby NM, Taal MW. Impact of malnutrition on health-related quality of life in persons receiving dialysis: a prospective study. Br J Nutr. 2021;127(11):1-9.

Kiberd J, Khan U, Stockman C, Radhakrishnan A, Phillips M, Kiberd BA, et al. Effectiveness of a Web-Based eHealth Portal for Delivery of Care to Home Dialysis Patients: A Single-Arm Pilot Study. Can J Kidney Health Dis. 2018;5:2054358118794415.

Lancaster K, Abuzour A, Khaira M, Mathers A, Chan A, Bui V, et al. The Use and Effects of Electronic Health Tools for Patient Self-Monitoring and Reporting of Outcomes Following Medication Use: Systematic Review. J Med Internet Res. 2018;20(12):e294.

Paniagua R, Amato D, Vonesh E, Guo A, Mujais S. Health‐related quality of life predicts outcomes but is not affected by peritoneal clearance: the ADEMEX trial. Kidney Int. 2005;67(3):1093–1104.

Freburger JK, Ellis AR, Wang L, et al. Comparative effectiveness of iron and erythropoiesis‐stimulating agent dosing on health‐related quality of life in patients receiving hemodialysis. Am J Kidney Dis. 2015;67(2):271‐282.

Dwyer JT, Larive B, Leung J, et al. Nutritional status affects quality of life in Hemodialysis (HEMO) Study patients at baseline. J Ren Nutr. 2002;12(4):213–223.

Brown EA. Influence of Reimbursement Policies on Dialysis Modality Distribution around the World. Clin J Am Soc Nephrol. 2019;14(1):10-2.

van der Tol A, Stel VS, Jager KJ, Lameire N, Morton RL, Van Biesen W, et al. A call for harmonization of European kidney care: dialysis reimbursement and distribution of kidney replacement therapies. Nephrology Dialysis Transplantation. 2020;35(6):979-86.

Published

2022-12-28

How to Cite

1.
Sala I, Rodrigues A. EQ-5D in dialysis units: a PROM with a view. Bull Dial Domic [Internet]. 2022 Dec. 28 [cited 2024 Apr. 19];5(4):33-41. Available from: https://www.bdd.rdplf.org/index.php/bdd/article/view/69733