. 2020 Jan;8(1):e000842.

doi: 10.1136/bmjdrc-2019-000842.

Health-related quality of life among patients with comorbid diabetes and kidney disease attending a codesigned integrated model of care: a longitudinal study

Edward Zimbudzi^{1

2}, Clement Lo^{1

3}, Sanjeeva Ranasinha¹, Helena Teede^{1

3}, Tim Usherwood^{4

5}, Kevan R Polkinghorne^{2

6}, Greg Fulcher^{7

8}, Martin Gallagher^{4

9}, Steven Jan^{4

10}, Alan Cass^{4

11}, Rowan Walker¹², Grant Russell¹³, Greg Johnson¹⁴, Peter G Kerr^{2

6}, Sophia Zoungas^{15

4}

Affiliations

¹ School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia.
² Department of Nephrology, Monash Health, Clayton, Victoria, Australia.
³ Diabetes and Vascular Medicine Unit, Monash Health, Clayton, Victoria, Australia.
⁴ The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.
⁵ Department of General Practice, The University of Sydney, Sydney, New South Wales, Australia.
⁶ School of Clinical Sciences, Monash University, Clayton, Victoria, Australia.
⁷ Department of Diabetes, Endocrinology and Metabolism, Royal North Shore Hospital School, St Leonards, New South Wales, Australia.
⁸ Northern Clinical School, The University of Sydney Northern Clinical School, St Leonards, New South Wales, Australia.
⁹ Concord Clinical School, The University of Sydney, Sydney, New South Wales, Australia.
¹⁰ Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
¹¹ Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
¹² Department of Renal Medicine, Alfred Health, Melbourne, Victoria, Australia.
¹³ Southern Academic Primary Care Research Unit, Department of General Practice, Monash University, Clayton, Victoria, Australia.
¹⁴ Diabetes Australia, Canberra, Australian Capital Territory, Australia.
¹⁵ School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia sophia.zoungas@monash.edu.

PMID: 31958294
PMCID: PMC6954749
DOI: 10.1136/bmjdrc-2019-000842

Health-related quality of life among patients with comorbid diabetes and kidney disease attending a codesigned integrated model of care: a longitudinal study

Edward Zimbudzi et al. BMJ Open Diabetes Res Care. 2020 Jan.

. 2020 Jan;8(1):e000842.

doi: 10.1136/bmjdrc-2019-000842.

Authors

Affiliations

¹ School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia.
² Department of Nephrology, Monash Health, Clayton, Victoria, Australia.
³ Diabetes and Vascular Medicine Unit, Monash Health, Clayton, Victoria, Australia.
⁴ The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.
⁵ Department of General Practice, The University of Sydney, Sydney, New South Wales, Australia.
⁶ School of Clinical Sciences, Monash University, Clayton, Victoria, Australia.
⁷ Department of Diabetes, Endocrinology and Metabolism, Royal North Shore Hospital School, St Leonards, New South Wales, Australia.
⁸ Northern Clinical School, The University of Sydney Northern Clinical School, St Leonards, New South Wales, Australia.
⁹ Concord Clinical School, The University of Sydney, Sydney, New South Wales, Australia.
¹⁰ Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
¹¹ Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
¹² Department of Renal Medicine, Alfred Health, Melbourne, Victoria, Australia.
¹³ Southern Academic Primary Care Research Unit, Department of General Practice, Monash University, Clayton, Victoria, Australia.
¹⁴ Diabetes Australia, Canberra, Australian Capital Territory, Australia.
¹⁵ School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia sophia.zoungas@monash.edu.

PMID: 31958294
PMCID: PMC6954749
DOI: 10.1136/bmjdrc-2019-000842

Abstract

Objective: To evaluate the impact of an integrated diabetes and kidney disease model of care on health-related quality of life (HRQOL) of patients with comorbid diabetes and chronic kidney disease (CKD).

Research design and methods: A longitudinal study of adult patients (over 18 years) with comorbid diabetes and CKD (stage 3a or worse) who attended a new diabetes kidney disease service was conducted at a tertiary hospital. A questionnaire consisting of demographics, clinical data, and the Kidney Disease Quality of Life (KDQOL-36) was administered at baseline and after 12 months. Paired t-tests were used to compare baseline and 12-month scores. A subgroup analysis examined the effects by patient gender. Multiple regression analysis examined the factors associated with changes in scores.

Results: 179 patients, 36% of whom were female, with baseline mean±SD age of 65.9±11.3 years, were studied. Across all subscales, HRQOL did not significantly change over time (p value for all mean differences >0.05). However, on subgroup analysis, symptom problem list and physical composite summary scores increased among women (MD=9.0, 95% CI 1.25 to 16.67; p=0.02 and MD=4.5, 95% CI 0.57 to 8.42; p=0.03 respectively) and physical composite scores decreased among men (MD=-3.35, 95% CI -6.26 to -0.44; p=0.03).

Conclusion: The HRQOL of patients with comorbid diabetes and CKD attending a new codesigned, integrated diabetes and kidney disease model of care was maintained over 12 months. Given that HRQOL is known to deteriorate over time in this high-risk population, the impact of these findings on clinical outcomes warrants further investigation.

Keywords: chronic kidney disease; quality of Life; type 2 diabetes.

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Conflict of interest statement

Competing interests: None declared.

Figures

**Figure 1**
Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) flow diagram of included patients. eGFR, estimated glomerular filtration rate.

**Figure 2**
Socioeconomic status in quintiles. The first quintile had individuals from the most disadvantaged areas and the fifth quintile comprised individuals from the least disadvantaged areas.

See this image and copyright information in PMC

References

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Health-related quality of life among patients with comorbid diabetes and kidney disease attending a codesigned integrated model of care: a longitudinal study

Affiliations

Health-related quality of life among patients with comorbid diabetes and kidney disease attending a codesigned integrated model of care: a longitudinal study

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical