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英国对慢性肾脏病相关贫血对患者和照护者影响的调查。

UK survey of patient and caregiver perspectives on the impact of chronic kidney disease-associated anaemia.

机构信息

Department of Cardiovascular Sciences, University of Leicester, Leicester, UK

John Walls Renal Unit, University Hospitals of Leicester NHS Trust, Leicester, UK.

出版信息

BMJ Open. 2024 Aug 17;14(8):e087802. doi: 10.1136/bmjopen-2024-087802.

Abstract

OBJECTIVE

Chronic kidney disease (CKD)-associated anaemia has substantial biopsychosocial impacts. This study explores the impact of CKD-associated anaemia and treatment preferences from the patient perspective.

DESIGN

Cross-sectional survey.

SETTING

Anonymised online survey implemented by Ipsos UK on behalf of the National Kidney Federation and GSK from October 2022 to January 2023.

PARTICIPANTS

Data were collected from UK adults living with CKD (self-reported).

PRIMARY AND SECONDARY OUTCOME MEASURES

Outcome measures were exploratory and not predefined. The cross-sectional survey was designed to explore the biopsychosocial impact of living with anaemia on individuals with CKD; their unmet needs; the treatment strategies typically implemented and the associated barriers/facilitators to adherence; the healthcare professional-patient relationship with regard to anaemia diagnosis and management.

RESULTS

Of 101 participants, 90 (89%) were patients with CKD and 11 (11%) were informal carers. 96 (95%) participants reported symptom(s) relevant to their experience of CKD. 88 (87%) participants reported symptom(s) associated with anaemia and 61 (64%) expressed an impact on daily life including 18 (19%) unable to perform daily activities, 13 (14%) unable to go to work and 9 (9%) reporting poor social life/interactions. 85 (84%) participants reported they have received treatment for anaemia: intravenous iron (n=55, 54%), iron tablets (n=29, 29%), erythropoietin-stimulating agents (ESAs) via an autoinjector (n=28, 28%), ESA injections via a syringe (n=24, 24%), ESA injections via a dialysis machine (n=17, 17%), folic acid (n=22, 22%) and blood transfusion (n=17, 17%). Six of seven (86%) participants who received their ESA from a healthcare professional at home preferred injections whereas 13/27 (48%) participants who injected themselves at home preferred oral tablets.

CONCLUSIONS

There is not a 'one-size-fits-all' approach to the management of CKD-associated anaemia. A personalised approach incorporating the treatment preferences of the individual should be explored when discussing treatment options.

摘要

目的

慢性肾脏病(CKD)相关贫血对患者有重大的身心影响。本研究从患者角度探讨 CKD 相关贫血及其治疗偏好的影响。

设计

横断面调查。

地点

匿名在线调查,由 Ipsos UK 代表英国国家肾脏基金会和 GSK 于 2022 年 10 月至 2023 年 1 月进行。

参与者

数据来自自报患有 CKD 的英国成年人。

主要和次要结果

结果是探索性的,不是预先确定的。横断面调查旨在探讨 CKD 患者贫血对其生活的身心影响;他们未满足的需求;通常实施的治疗策略以及与依从性相关的障碍/促进因素;与贫血诊断和管理相关的医患关系。

结果

101 名参与者中,90 名(89%)为 CKD 患者,11 名(11%)为非正式照顾者。96 名(95%)参与者报告了与 CKD 相关的症状。88 名(87%)参与者报告了与贫血相关的症状,61 名(64%)表示对日常生活有影响,包括 18 名(19%)无法进行日常活动,13 名(14%)无法上班,9 名(9%)报告社交生活/互动不佳。85 名(84%)参与者报告接受了贫血治疗:静脉铁(n=55,54%)、铁剂(n=29,29%)、ESA 自动注射器(n=28,28%)、ESA 注射器(n=24,24%)、ESA 透析机(n=17,17%)、叶酸(n=22,22%)和输血(n=17,17%)。在 7 名(86%)在家从医护人员处获得 ESA 的参与者中,有 6 名更喜欢注射,而在 27 名(48%)在家注射的参与者中,有 13 名更喜欢口服片剂。

结论

CKD 相关贫血的管理没有“一刀切”的方法。在讨论治疗方案时,应探讨纳入个体治疗偏好的个性化方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b6f/11331844/3377be32377b/bmjopen-14-8-g001.jpg

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