Abstract: FR-PO867
Sociodemographic Characteristics and Symptom Treatment Status of Hemodialysis Patients With Pain, Depression, and/or Fatigue
Session Information
- Diversity and Equity in Kidney Health - II
November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Diversity and Equity in Kidney Health
- 800 Diversity and Equity in Kidney Health
Authors
- Devaraj, Susan M., University of Pittsburgh Department of Medicine, Pittsburgh, Pennsylvania, United States
- Roumelioti, Maria-Eleni, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States
- Yabes, Jonathan, University of Pittsburgh Department of Medicine, Pittsburgh, Pennsylvania, United States
- Schopp, Mary Margaret, University of Pittsburgh Department of Medicine, Pittsburgh, Pennsylvania, United States
- Steel, Jennifer L., University of Pittsburgh Department of Medicine, Pittsburgh, Pennsylvania, United States
- Erickson, Sarah Jane, University of New Mexico Department of Psychology, Albuquerque, New Mexico, United States
- Rollman, Bruce L., University of Pittsburgh Department of Medicine, Pittsburgh, Pennsylvania, United States
- Weisbord, Steven D., University of Pittsburgh Department of Medicine, Pittsburgh, Pennsylvania, United States
- Unruh, Mark L., University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States
- Jhamb, Manisha, University of Pittsburgh Department of Medicine, Pittsburgh, Pennsylvania, United States
Background
End Stage Kidney Disease patients on hemodialysis (HD) often experience clinically significant pain, fatigue and depressive symptoms, and efforts to identify and manage symptom burden are essential to improve patient outcomes. We sought to identify sociodemographic differences by symptom burden and treatment among HD patients consented for a multi-center trial of collaborative care to reduce symptom burden (TACcare).
Methods
Protocol-eligible patients screened positive for clinical levels of pain (Likert scale ≥4), fatigue (Likert scale ≥5), and/or depression (Patient Health Questionnaire-9 score ≥10) and provided informed consent to participate in the trial (years 2018-2022). We used ANOVA or Fisher’s exact tests to analyze the cross-sectional associations of age, race, ethnicity, gender, employment, education, marital status, home neighborhood walkability, and tobacco, alcohol, and illicit drug use with symptom experience and treatment status (receiving psychosocial/behavioral treatment vs. willing to receive treatment) at baseline.
Results
Of n=215 participants, 55% were male, 19% were Hispanic, 29% were Black/African American, 17% were American Indian/Alaskan Native, and 60% had an annual income <$20k. Patients with depression were younger than those without [age: 56 (SD:13) vs. 60 (14) years; p=0.02]. The percentage of patients experiencing pain was inversely proportional to annual household income (<$20k: 75%, $20-40k: 80%, $40-60k: 69%, >$60k: 36%; p=0.04). There was a significant association between experiencing pain and history of illicit drug use, with pain most prevalent with use >5 years ago (never used: 70%, used <5 years ago: 57%, used >5 years ago: 92%; p=0.03). No significant differences in symptom count were noted across any other sociodemographic subgroup. Women were more likely than men to be receiving treatment for symptoms (52% vs. 34%, p=0.01).
Conclusion
Sociodemographic correlates with symptoms could help inform targets to improve pain, fatigue, and depression identification and treatment in HD patients. Being male may indicate less frequent symptom treatment, while income and history of illicit drug use may be important to consider in identifying and managing pain.
Funding
- NIDDK Support