Abstract: FR-PO438
Identifying Symptom Clusters and Associated Social Determinants of Health in Patients with ESKD and Chronic Pain: A Secondary Analysis of the HOPE Trial
Session Information
- Hemodialysis Epidemiology and Outcomes
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Steel, Jennifer L., University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
- Lockwood, Mark, University of Illinois Chicago, Chicago, Illinois, United States
- Brintz, Carrie E., Vanderbilt University Medical Center, Nashville, Tennessee, United States
- Cavanaugh, Kerri L., Vanderbilt University Medical Center, Nashville, Tennessee, United States
- Cheatle, Martin, University of Pennsylvania, Philadelphia, Pennsylvania, United States
- Cukor, Daniel, New York University Grossman School of Medicine, New York, New York, United States
- Dember, Laura M., University of Pennsylvania, Philadelphia, Pennsylvania, United States
- Doorenbos, Ardith Zwyghuizen, University of Illinois Chicago, Chicago, Illinois, United States
- Howell, Heather B., Yale University, New Haven, Connecticut, United States
- Keefe, Francis J., Duke University, Durham, North Carolina, United States
- Kimmel, Paul L., National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, United States
- Liebschutz, Jane, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
- Mcneil, Daniel W., University of Florida, Gainesville, Florida, United States
- Unruh, Mark L., University of New Mexico School of Medicine, Albuquerque, New Mexico, United States
- Yabes, Jonathan Guerrero, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
- Hsu, Jesse Yenchih, University of Pennsylvania, Philadelphia, Pennsylvania, United States
- Jhamb, Manisha, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
Group or Team Name
- HOPE Consortium.
Background
Identifying symptom clusters and associated social determinants of health (SDOH) among people with chronic pain and ESKD may facilitate more effective treatment of symptoms
Methods
The HOPE Consortium Trial to Reduce Pain and Opioid Use in Hemodialysis, designed to address chronic pain in adults receiving maintenance HD, enrolled 643 patients with moderate to severe chronic pain. We used latent profile analysis to identify patterns of an a priori symptom cluster (pain, fatigue, anxiety, depression and sleep disturbances) with baseline measures of the Brief Pain Inventory, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, the PROMIS Fatigue and Sleep subscales. We used multinomial logistic regression to assess associations between symptom clusters and SDOH (obtained by self-report and geocoding).
Results
Five symptom cluster phenotypes were characterized based on fit statistics, interpretability, and between-class heterogeneity. There was significant variability in perceived discrimination across the symptom clusters (p<0.01). Living in a racially segregated neighborhood was associated with a symptom cluster with high depressive symptoms, relative to “average” symptom cluster (Adjusted OR=1.03, p=0.02).There were no significant associations of symptom clusters with education level, household income, area deprivation index, rural/urban community, walkability index or Gini index of income inequality.
Conclusion
The symptom clusters identified are potentially important to clinicians and researchers for addressing symptom burden. System and individual level SDOH may be important factors to include when developing interventions focused on reducing symptom burden in those with ESKD and chronic pain.
Symptom cluster domains in patients with ESKD and chronic pain
Funding
- NIDDK Support