Development and Validation of a Kidney Transplant-Specific Measure of Treatment Burden
1Mayo Clinic, Rochester, MN, 2Mayo Clinic, Jacksonville, FL, 3Mayo Clinic, Scottsdale, AZ
Meeting: 2022 American Transplant Congress
Abstract number: 20
Keywords: Morbidity, Outcome, Psychosocial, Quality of life
Topic: Clinical Science » Kidney » 33 - Kidney Psychosocial
Session Information
Session Time: 3:30pm-5:00pm
Presentation Time: 4:30pm-4:40pm
Location: Hynes Ballroom A
*Purpose: Treatment burden refers to the work involved in managing one’s health and its impact on well-being. Treatment burden has been associated with nonadherence and decreased quality of life in people with chronic illnesses. No kidney transplant (KT)-specific measure of treatment burden exists. The aim of this study was to develop and validate a KT-specific supplement to the Patient Experience with Treatment and Self-Management (PETS) general measure of treatment burden.
*Methods: After drafting KT-specific survey items and pretesting them in cognitive interviews, we conducted a cross-sectional survey study involving KT recipients from Mayo Clinic Minnesota, Arizona, and Florida. Exploratory factor analysis (EFA) was used to identify domains for scaling the KT-specific supplement. Construct and known-groups validity were determined by correlating scores on the KT-specific scales with scores on the PETS and other established surveys and by comparing scores across groups of patients. Demographics, medications, and estimated glomerular filtration rate (eGFR) were abstracted from the electronic medical record.
*Results: Survey respondents (n=167) had a mean age of 61 years old (range 21-86), were 55.7% male, and received a KT on average 4.0 years ago. Three domains were identified by EFA (transplant function, transplant self-management, and transplant adverse effects) and their scale scores determined. Higher scores on these KT-specific scales were correlated with higher PETS treatment burden, worse physical and mental health, more bother due to medication side effects, and lower self-efficacy (p<0.0001). Patients taking more medications reported significantly higher burden on the transplant self-management scale, whereas patients with lower kidney function reported significantly higher burden on the transplant function scale.
| KT-Specific Scale | Upper Quartile of Number of Medications | eGFR < 30 ml/min/1.73 m2 | ||||
| No (n=121) | Yes (n=44) | p-value | No (n=137) | Yes (n=18) | p-value | |
| Transplant Function | 35.2 ± 26.0 | 35.3 ± 27.5 | 0.91 | 32.1 ± 24.6 | 54.2 ± 29.7 | 0.004 |
| Transplant Self-Management | 19.5 ± 18.1 | 27.3 ± 19.4 | 0.02 | 20.5 ± 18.4 | 28.5 ± 20.3 | 0.11 |
| Transplant Adverse Effects | 42.7 ± 25.2 | 43.2 ± 23.4 | 0.96 | 41.6 ± 23.6 | 54.9 ± 30.5 | 0.08 |
*Conclusions: We developed and validated a KT-specific supplement to the PETS general measure of treatment burden. Scores may help providers identify recipients at high-risk for nonadherence and serve as an endpoint in future clinical trials designed to improve adherence after KT.
To cite this abstract in AMA style:
Lorenz E, Petterson T, Zaniletti I, Lackore K, Johnson B, Mai M, Nair S, Bentall A, Yost K, Eton D. Development and Validation of a Kidney Transplant-Specific Measure of Treatment Burden [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/development-and-validation-of-a-kidney-transplant-specific-measure-of-treatment-burden/. Accessed November 21, 2024.« Back to 2022 American Transplant Congress