Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
- Psychosocial Factors Associated with Medication Adherence Based on Self Reports in Kidney Allograft Recipients: Baseline Findings from the PRIMA (ImPRoving Adherence to Immunosuppressive Therapy by Mobile Internet Application) Study.
- Prevention of Poor Psychosocial Outcomes in Living Kidney and Liver Donors: Feasibility and Efficacy in a Randomized Controlled Trial
We describe the frequency of psychosocial distress among Canadian patients with advanced chronic kidney disease (CKD), and compare distress between pre-dialysis, dialysis patients and kidney transplant recipients (KTRs).
We recruited a cross-sectional convenience sample of pre-dialysis and dialysis patients from two hospital-based clinics and dialysis units; as well as stable KTRs followed at our transplant center. We used the Distress Assessment and Response Tool (DART) to assess psychosocial distress, and collected demographic information using a tablet-based electronic data capture system. The DART includes the PHQ-9 for depression, GAD-7 for anxiety and the Social Difficulties Inventory. The presence of anxiety, depression, and social difficulties was defined as a score of ≥10 on the GAD-7, PHQ-9, and SDI, respectively; any distress as a score of ≥10 on at least one of the above scales.
Out of 175 patients (82 KT recipients, 26 pre-dialysis 67 dialysis); mean(±SD) age 56(±15) years, 55% male, 37% (37/82) of KT recipients and 31%(8/26) of pre-dialysis patients reported any distress, compared to 60%(40/67) of dialysis patients (p=0.006). Compared to hemodialysis patients, KT recipients had lower rates of social difficulties (34%vs.51%, p=0.049) and any distress (37%vs.58%, p=0.013); the difference between rates of depression (26%vs.18%) was not statistically significant (p=0.298). Psychosocial distress was associated with non-Caucasian ethnicity (57%vs.35%, p=0.004) with highest rates among African- (73%) and Asian-Canadians (51%). In a multivariable adjusted (age, gender, ethnicity, education, comorbidity) logistic regression model KT remained significantly associated with less psychosocial distress compared to dialysis (OR=0.42, 95%CI=0.18–0.97; P=0.043).
These preliminary results suggest that psychosocial distress is very frequent among those with CKD. KT is associated with lower odds of psychosocial distress compared to patients on dialysis. A systematic approach to distress screening and management may improve psychosocial and medical outcomes for these patients.
CITATION INFORMATION: Richardson C, Belenko D, Mucsi E, Edwards N, Wong D, Novak M, Li M, Mucsi I. Psychosocial Distress in Chronic Kidney Disease: Benefits of Kidney Transplantation. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Richardson C, Belenko D, Mucsi E, Edwards N, Wong D, Novak M, Li M, Mucsi I. Psychosocial Distress in Chronic Kidney Disease: Benefits of Kidney Transplantation. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/psychosocial-distress-in-chronic-kidney-disease-benefits-of-kidney-transplantation/. Accessed December 6, 2019.
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