title: Health-related quality of life is maintained in hemodialysis patients receiving pharmaceutical care: a 2-year randomized, controlled study.
abstract: End-stage renal disease and initiation of hemodialysis (HD) adversely affect health-related quality of life (HRQOL). There are currently no data evaluating the effect of pharmaceutical care (PC) on HRQOL in HD patients. HD patients were randomized to receive PC; one-on-one, in-depth medication reviews conducted by a clinical pharmacist or Standard of Care (SOC); and brief medication reviews conducted by dialysis nurses. The renal quality of life profile (RQLP) was administered at baseline and then at 1 and 2 years after study initiation. The RQLP is a 43-item questionnaire that has 5 dimensions: Eating/Drinking, Physical Activities, Leisure Time, Psychosocial Activities, and Impact of Treatment, where increasing scores reflect worsening of HRQOL. A total of 107 patients were enrolled (SOC: n=46; PC: n=61). Besides gender, there were no differences in the demographics or the baseline total RQLP scores. The mean+/-SD total RQLP scores at Year 1 were significantly worse in SOC compared with PC (88+/-31 vs. 71+/-34, respectively; P=0.03). Significant worsening of Eating and Drinking (5.9+/-3.3 vs. 4.4+/-3.1, respectively; P=0.04), Physical Activities (37+/-13.6 vs. 30+/-16.3, respectively; P=0.04), and Leisure Time scores (8.3+/-3.4 vs. 5.9+/-3.6, respectively; P=0.03) was also observed in the SOC group. After 2 years, only the SOC patients had worsening of Leisure Time (7.5+/-3.0 vs. 5.2+/-3.9, respectively; P=0.04). No other parameters were different between the groups after 2 years. These data indicate that patients who have clinical care provided by pharmacists do not have worsened HRQOL after 1 year and are able to maintain HRQOL for an additional year.
authors.affiliation: Albany College of Pharmacy and Health Sciences, New York, 12208, USA. bartonpa@acp.edu
authors.forename: Amy Barton
authors.initials: AB
authors.lastname: Pai
authors.forename: Alex
authors.initials: A
authors.lastname: Boyd
authors.forename: Alicia
authors.initials: A
authors.lastname: Chavez
authors.forename: Harold J
authors.initials: HJ
authors.lastname: Manley
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010593:Pharmaceutical Services; D010595:Pharmacists; D011788:Quality of Life; D006435:Renal Dialysis / Q000523:psychology*; D012727:Sex Characteristics