Abstract: TH-PO800
Hospitalization and Missed Dialysis Treatments Are More Common in Hemodialysis Patients with Depressive Symptoms
Session Information
- Dialysis: Epidemiology, Outcomes, Clinical Trials - Non-Cardiovascular - I
November 02, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Dialysis
- 607 Dialysis: Epidemiology, Outcomes, Clinical Trials - Non-Cardiovascular
Authors
- Aebel-Groesch, Kathryn M., DaVita, Inc, Denver, Colorado, United States
- Dunn, Duane V., DaVita, Inc, Denver, Colorado, United States
- Major, Angie, DaVita, Inc, Denver, Colorado, United States
- Mayes, Sean, DaVita, Inc, Denver, Colorado, United States
- Benner, Deborah A., DaVita, Inc, Denver, Colorado, United States
- Tentori, Francesca, DaVita Clinical Research, Minneapolis, Minnesota, United States
Background
Depression is common in end-stage renal disease and is likely to have a negative impact on patient engagement in self-care and clinical outcomes. Here we characterized incidence of hospitalization and missed dialysis treatments among in-center hemodialysis patients who screened positive for depressive symptoms.
Methods
We analyzed data from a large dialysis organization electronic health record database. Depression screenings were performed biannually (May 2016-April 2017) with the PHQ-2 scale (range 0-6). Patients with active diagnosis of depression, bipolar disorder, cognitive impairment, language barriers, or who were hospitalized were not screened. Rates of hospitalization and of missed dialysis treatments due to non-adherence in the 3 months after screening were compared in patients with depressive symptoms (PHQ-2 score ≥ 2) and those without.
Results
A total of 54,441 (17.3%) screenings were positive for depression. The hospitalization rate was higher among those with depressive symptoms compared to those without (2.2 vs 1.5 admissions per patient-year). Patients who screened positive for depression were also more likely to miss dialysis treatments (7.7 vs 5.1 missed HD session per patient-year). Overall, patients with higher PHQ-2 scores were more likely to have higher hospitalization and missed treatment rates.
Conclusion
These findings indicate that hemodialysis patients who screen positive for depression are more likely to be hospitalized and be non-adherent to dialysis treatment schedules. Since the PHQ-2 may underestimate actual depression rates, our results represent conservative estimates of the possible impact of depression on clinical outcomes. Clinical initiatives should be designed to specifically target high-risk patients who screen positive for depression.
Funding
- Commercial Support – DaVita, Inc