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Kidney Week

Abstract: TH-PO232

Quality of Life in Caregivers of Patients Receiving Standard vs. Extended Hours Hemodialysis: The Co-ACTIVE Substudy of the ACTIVE Dialysis Trial

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Nataatmadja, Melissa S., Sunshine Coast University Hospital, Birtinya, Queensland, Australia
  • Krishnasamy, Rathika, Sunshine Coast University Hospital, Birtinya, Queensland, Australia
  • Zuo, Li, Peking University People's Hospital, Beijing, China
  • Hong, Daqing, Sichuan Provincial People's Hospital, Chengdu, SiChuan, China
  • Smyth, Brendan, The George Institute for Global Health, Sydney, New South Wales, Australia
  • Jun, Min, The George Institute for Global Health, Sydney, New South Wales, Australia
  • de Zoysa, Janak, Waitemata District Health Board, Auckland, New Zealand
  • Howard, Kirsten, University of Sydney, School of Public Health, Sydney, New South Wales, Australia
  • Chunlai, Lu, Shanghai 85th Hospital, Shanghai, China
  • Perkovic, Vlado, The George Institute for Global Health, Sydney, New South Wales, Australia
  • Jardine, Meg J., The George Institute for Global Health, Sydney, New South Wales, Australia
  • Gray, Nicholas A., Sunshine Coast University Hospital, Birtinya, Queensland, Australia
Background

Caregivers of dialysis patients experience significant burden and lower quality of life (QOL) compared to the general population. Extended hours dialysis has benefits for the patient, however little is known about its effects on caregivers.

Methods

We evaluated QOL amongst caregivers of the ACTIVE Dialysis trial participants who were randomised for 12 months to receive extended (median 24 hours/week) or standard (12 hours/week) hemodialysis. Caregivers completed the EuroQOL-5 Dimension-3 Level (EQ5D-3L), Short Form-36 (SF-36) physical component summary (PCS), mental component summary (MCS) and SF-6D, and Personal Wellbeing Index (PWI). Primary outcome was change in QOL scores from study entry to follow-up.

Results

A total of 40 participated in this longitudinal study. Most caregivers were female (64%) and Asian (94%). At baseline, QOL scores in caregivers of patients randomised to standard and extended hours hemodialysis were similar (Table 1). At follow-up, there was a significant difference in the mean change in EQ5D-3L between those allocated to standard versus extended hours dialysis (-0.022±0.16 vs -0.197±0.30, p=0.04). There were no differences between standard and extended hours groups in mean change in PCS (-5.6±9.8 vs -1.2±9.8, p=0.2), MCS (-0.5±7.1 vs -4.1±11.2, p=0.4), SF-6D (-0.04±0.1 vs 0.03±0.12, p=0.8) or PWI (0.00±20.4 vs -2.3±17.6, p=0.9).

Conclusion

Our study found significantly poorer health utility amongst caregivers of patients randomised to extended hours dialysis, but no difference in QOL measures. This suggests extended hours dialysis may have a negative impact on caregivers, although our study has a number of limitations including small sample size and short follow-up, and the results should be regarded as exploratory. Further studies are needed to better understand the impact of dialysis on caregivers to inform the provision of support services.

Table 1. Baseline characteristics of caregivers in the Co-ACTIVE study
 Standard (n=16)Extended (n=24)p-value
Mean age, years (SD)54.6 (10.3)53.4 (13.0)0.9
Sex, %
Female
Male
71.4
28.6
59.1
40.9
0.4
Marital status, %
Married/defacto
Single
92.9
7.1
100
-
0.4
Caregiver QOL score, mean (SD)
EQ5D
SF-36 PCS
SF-36 MCS
SF-6D
PWI
0.920 (0.12)
50.0 (7.3)
50.4 (10.0)
0.74 (0.1)
63.8 (21.1)
0.911 (0.12)
47.9 (8.5)
48.3 (8.8)
0.71 (0.1)
62.5 (23.8)
0.8
0.4
0.4
0.4
0.8