Design and rationale of health-related quality of life and patient-reported outcomes assessment in the Frequent Hemodialysis Network trials

BACKGROUND: End-stage renal disease patients experience significant impairments in health-related quality of life (HRQOL). Testing various strategies to improve patient HRQOL in multi-center clinical trials, such as the Frequent Hemodialysis Network (FHN) trials is vitally important.

AIMS: The aim of this paper is to describe the design and conduct of HRQOL and patient-reported outcomes (PRO) assessment in the FHN trials.

METHODS: In the FHN trials, HRQOL was examined as a multidimensional concept, and the SF-36 RAND Physical Health Composite score was one of the co-primary outcomes. The instruments completed to assess HRQOL included the Medical Outcomes Study Short Form SF-36, Health Utilities Index 3, Sleep Problems Index, Beck Depression Inventory and feeling thermometer. These instruments have been shown to have high reliability, validity and responsiveness to change in the end-stage renal disease population. Additional items evaluating PRO including sexual function, time to recovery after dialysis and patients' self-perceived burden to caregiver were also assessed. All questionnaires were administered by trained interviewers using computer-assisted telephone interviewing to ensure blinding and minimizing selection bias. Interim analysis reveals that these instruments can be used to collect a comprehensive set of HRQOL measures with minimal patient burden.

CONCLUSIONS: Accurate measurement of HRQOL and PRO can help us test whether hemodialysis interventions improve the health and well-being of this compromised patient population. We have shown that a comprehensive set of HRQOL measures can be centrally collected through telephone interviews in a blinded fashion, in a way that is well tolerated with minimum respondent burden.

Contributors

Jhamb, Manisha and Manjula K. Tamura, Jennifer Gassman, Amit X. Garg, Robert M. Lindsay, Rita S. Suri, George Ting, Fredric O. Finkelstein, Scott Beach, Paul L. Kimmel, Mark Unruh
for the Frequent Hemodialysis Network Trial Group

Publication

Journal: Blood Purification
Volume: 31
Issue: 1-3
Pages: 151 - 8
Year: 2011
DOI: 10.1159/000321855

Further Study Information

Current Stage: Not Applicable
Date:
Funding source(s): This work was supported by grants from the National Institute of Diabetes and Digestive and Kidney Diseases (U01 DK03005) and Dr. Mark Unruh (DK077785).


Health Area

Disease Category: Kidney disease

Disease Name: End-stage kidney disease

Target Population

Age Range: Unknown

Sex: Either

Nature of Intervention: Hemodialysis

Stakeholders Involved

- None

Study Type

- Systematic review of outcome measures/measurement instruments
- Systematic review of outcomes measured in trials

Method(s)

- Literature review

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