SP698TREATMENT BURDEN AND ITS IMPACT ON QUALITY OF LIFE AMONG CHRONIC KIDNEY DISEASE PATIENTS

Abstract

INTRODUCTION: Chronic kidney disease (CKD) is associated with multiple comorbidities and disease related progressive complications. The management of these places significant burden on patients and results in impairment of their health-related quality of life (HR-QOL). Little is known about treatment-related burden in patients with CKD whether receiving dialysis or not. This study aimed to investigate the magnitude of treatment-related burden and its impact on HR-QOL among CKD patients in Qatar. METHODS: This was a mixed-method, sequential explanatory study conducted at Fahad Bin Jassim Kidney Center in Qatar (largest dialysis and pre-dialysis center in Qatar). Treatment-related burden and HR-QOL were assessed quantitatively using the Treatment Burden Questionnaire (TBQ) and the Kidney Disease Quality of Life (KDQOLTM) questionnaire, respectively. To gain a deeper insight, qualitative one-toone semi-structured interviews were conducted among the CKD patients. Quantitative data were analyzed descriptively and inferentially using SPSS version 24. Thematic content analysis was performed for the qualitative data. Study was approved by our health organization IRB. RESULTS: Two hundred-eighty CKD patients (hemodialysis = 223 and pre-dialysis (GFR<20) = 57) were included in the study. 65% of the patients expressed low treatment-related burden, while 35% reported moderate to high burden. Furthermore, hemodialysis patients experienced significantly higher treatment burden compared to pre-dialysis patients with median (IQR) of 45 (36) versus 25 (33), respectively (p<0.001). Medication burden and lifestyle change burden were the highest perceived treatment-related burden, followed by administrative burden, social burden, and financial burden. There was a strong, negative correlation between TBQ score and KDQOL-36™ score [rs (251) = -0.616, p<0.001]. Thematic content analysis identified religion and faith in God as well as quality of the care provided as factors that reduce perceived treatment burden and improve patients' HR-QOL. Conversely, medication burden, lifestyle changes, challenges with international travelling, financial burden, and empathy were factors that worsen perceived treatment-related burden and HR-RQOL. CONCLUSIONS: This study suggests that treatment-related burden should be considered in CKD management strategies. Factors that increase this burden should be considered when designing healthcare interventions directed to CKD patients.