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Quality‐of‐Life, Risk for Malnutrition, and Polypharmacy Among Persons on Haemodialysis in Trinidad and Tobago
Author(s) -
Prout Patrice,
Nichols Selby
Publication year - 2017
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.31.1_supplement.791.8
Subject(s) - medicine , polypharmacy , anthropometry , malnutrition , quality of life (healthcare) , diabetes mellitus , dialysis , gerontology , physical therapy , pediatrics , family medicine , environmental health , nursing , endocrinology
Objective Locally, the number of person on dialysis has increased significantly in the last ten (10) years. This has been driven largely by the high rates of hypertension and diabetes which account for over 50% of all annual health visits to health facilities locally. In this study, we evaluated the quality‐of‐life and risk of malnutrition among person on dialysis. Methods A case‐control design was used in this study. Cases consisted of persons currently on haemodialysis. Controls consisted of clients attending the same clinics that have been diagnosed and are being treated for hypertension (HTN) and diabetes mellitus (DM). Face‐to‐face interviews were conducted using a standardized questionnaire consisting of a food frequency questions, quality‐of‐life, physical activity and socio‐demographic items. Responses from the quality‐of‐life instrument (SF 12) was used to generate physical component scores (PCS) and mental component scores (MCS). Risk of malnutrition was evaluated using the Mini‐Nutritional Assessment (MNA) instrument. Persons taking more five or more medications were categorised as exhibiting polypharmacy. Anthropometry was assessed using recommended procedures. The study was approved by the Ethics Committee, the University of the West Indies. Results Three Hundred and Ninety persons (cases = 130, controls DM =130, HTN=130) participated in the study. There were no significant differences in the ages and BMI by gender between cases and controls. When compared to persons with hypertension and diabetes, participants on dialysis had significantly lower quality‐of‐life scores (pcs = 31.1 ± 6.0 vs. 39.6 ± 8.5; p<0.001); (MSC = 43.5± 6.0 vs. 55.7 ± 7.6; p < 0.001) and nutritional risk scores (11.5 ± 2.1 vs. 9.1 ± 2.7; p < 0.05) independent of sex. In addition, persons on dialysis were significantly more likely to be at increased risk for malnutrition odds ratio (OR) = 6.5 (95% confidence Intervals (CI): 3.9; 11.1 p < 0.001) and quality‐of‐life PCS (OR) = 1.6, 95%CI: 1.5, 1.7): MSC (OR) = 18.9, 95%CI: 10.8, 32.4). MSC scores were significantly inversely correlated with the number of medications being used by persons not on haemodialysis (r = −0.23; p<001) while PCS scores were significantly inversely associated with number of medications used by persons on haemodialysis Conclusion Person on haemodialysis had a poorer quality‐of‐life, higher risk for malnutrition and polypharmacy compared to participants who had hypertension and diabetes mellitus. In addition, the number of medications used was a significant predictor of quality‐of‐life components. Support or Funding Information None