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Abstract: TH-PO313

The Feasibility of Using Computerized Adaptive Testing (CAT) to Assess PD Patients' Quality of Life and Symptom Burden

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Author

  • Finkelstein, Fredric O., Yale University, New Haven, Connecticut, United States
Background

Dialysis pts complain of myriad symptoms that negatively impact on their HRQOL and are often not appreciated by health care providers (HCP). How best to document these symptoms and their impact on pts and then incorporate the information into rx plans is challenging. Recent work has suggested that using CAT could provide a useful way for HCP to better understand difficulties experienced by pts.

Methods


This study was undertaken as a feasibility study. 20 questions, incorporating common symptoms reported by ESRD pts, were incorporated into a CAT program developed by the authors and Owl Insights. Questions dealing with pain, depression, anxiety, and sleep would expand from 1-2 items into more robust assessments if responses indicated domains were problematic. For example, depression screening was done with the PHQ2 which expanded to the PHQ9 if PHQ2 scores were >3. If pts reported problems with anxiety, then the Generalized Anxiety Disorder (GAD)7 questionnaire was administered. Pts were also given the option to free text any domains they wanted to discuss with their HCP. Questionnaires were given on an iPAD just prior to a clinic visit; results were printed and given to the HCP at the visit. The study was performed over 6 months with pts being asked to complete the questionnaires q 2 mths

Results

All 48 English speaking pts in our inner-city PD program were assked to participate. The mean +/-SD age was 60 +/-14. 55% were male, 43% AA, 33% white, 20% Hisp, 5% Asian. 92% completed the initial questionnaire; 86% completing this questionnaire completed the 2nd. The mean time to complete the questionnaire was 11 +/-2 min. 75% asked for assistance with the questionnaire.

75% complained of restless legs. 47% had PHQ2 scores of >3 and completed the PHQ9. 50% reported significant sleep problems and completed the sleep questionnaire. 30% were troubled by anxiety and completed the GAD7. Other problems frequently reported included fatigue, loss of energy, pain, and pruritis.
HCPs (4 nurses, 2 dieticians, 7 MDs, 1 sw, and 2 PAs) uniformly found the questionnaires helpful with their clinic visits, enabling them to focus on reported problem areas.

Conclusion


The present study demonstrates that using CAT questionnaires is feasible and is a useful way to capture PD pt perceptions of their symptoms and HRQOL and can enable HCP to perhaps better address pt domains of difficulty.

Funding

  • Commercial Support