Patient Reported Outcomes Following Renal Transplantation: The Future of Holistic Post-Transplant Care
1Roy Calne Transplant Unit, Department of Transplantation, Addenbrooke's Hospital, Cambridge, United Kingdom, 2Department of Nephrology and Transplantation, Guy’s and St. Thomas’ Hospital, London, United Kingdom, 3King's College London, London, United Kingdom
Meeting: 2022 American Transplant Congress
Abstract number: 1605
Keywords: Kidney transplantation, Outcome, Psychiatric comorbidity, Quality of life
Topic: Clinical Science » Ethics » 22 - Psychosocial and Treatment Adherence
Session Information
Session Name: Psychosocial and Treatment Adherence
Session Type: Poster Abstract
Date: Tuesday, June 7, 2022
Session Time: 7:00pm-8:00pm
Presentation Time: 7:00pm-8:00pm
Location: Hynes Halls C & D
*Purpose: Patients with renal disease prioritise symptoms and functionality over the biochemistry and clinical guidelines, which clinicians traditionally rely on. Whilst kidney transplantation is expected to offer better survival and quality of life than dialysis, many recipients suffer limitations in their daily lives, due to factors associated with transplantation, such as immunosuppression side effects and infection. This study aimed to assess patient reported outcomes after kidney transplantation, to improve understanding and facilitate enhanced holistic post-transplant care.
*Methods: A retrospective analysis of a prospectively maintained database of patients completing PHQ-9 and GAD-7 questionnaires, each consecutive year following renal transplantation, was conducted between 2013 and 2020 at a single institution.
*Results: 698 patients returned PHQ-9 and GAD-7 questionnaires during the time period. After excluding incomplete records, 599 patients were included in the final analysis. There was a male preponderance (81.0%), and median age of 54 (range 19-84). The median number of consecutive completed annual questionnaires per patient was 3 (range 1-8). The majority of patients (70.1%) scored no depression on PHQ-9, followed by 18.5% reporting mild depression, with 11.3% falling into moderate to severe categories. Mean score at last assessment was worse than at first assessment (4.0 vs 2.6, p<0.001), but remained within the ‘no depression’ category. With GAD-7, 83.1% of patients scored minimal anxiety, followed by 9.6% reporting mild anxiety, with the remaining 7.1% scoring moderate or severe anxiety. Mean score at last assessment was worse than at first assessment (2.9 vs 1.9, p<0.001), but remained within the ‘minimal anxiety’ range.
*Conclusions: Most patients undergoing renal transplantation do not suffer from depression or anxiety post-operatively, however, a significant proportion experience moderate to severe depression and anxiety. Prospective studies understanding the causes, and links with routinely collected biochemical data, will enable clinicians to identify and support at risk patients, delivering holistic evidenced based care.
To cite this abstract in AMA style:
Spiers HV, Frame S, Heape R, Clark K, Altinar A, Ross L, Wells H, Simpson A, Chilcot J, Hughes L, Summers DM, Weinman J, Hotopf M, Cronin AJ. Patient Reported Outcomes Following Renal Transplantation: The Future of Holistic Post-Transplant Care [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/patient-reported-outcomes-following-renal-transplantation-the-future-of-holistic-post-transplant-care/. Accessed December 3, 2024.« Back to 2022 American Transplant Congress