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Activation and disease control of patients on chronic hemodialysis: An observational study
Sara Ramírez-Sánchez1, María Jesús Soriano-Munuera2, Elena Lucia Gras-Colomer3
1Bioquímica y Ciencias Biomédicas, Universitat de València, Valencia, Spain.
Insights
Patient activation, the willingness to manage health, is low in hemodialysis patients. Higher activation correlates with arteriovenous fistulas, better blood flow, and less interdialytic weight gain.
Area of Science:
- Nephrology
- Patient Health Management
- Chronic Disease Care
Background:
- Patient activation is crucial for managing health, but often low in chronic disease patients.
- Limited data exists on patient activation levels in hemodialysis populations.
- This study addresses the gap in understanding hemodialysis patient activation.
Purpose of the Study:
- To assess the patient activation level in individuals undergoing chronic hemodialysis.
- To investigate the relationship between patient activation and key disease control parameters in hemodialysis patients.
Main Methods:
- A cross-sectional observational study involving 96 hemodialysis patients.
- Patient activation was measured using the Patient Activation Measure (PAM-13) questionnaire.
- Statistical analyses included Spearman's correlation, multiple linear regression, and logistic regression.
Main Results:
- The average PAM-13 score was 63.19 (±15.21), indicating generally low activation.
- Significant associations were found between activation levels and vascular access type (P=0.003).
- Higher activation correlated with increased blood flow (P=0.024) and lower interdialytic weight gain (P=0.008).
Conclusions:
- Patient activation is notably low among patients receiving chronic hemodialysis.
- Favorable indicators include arteriovenous fistula use, higher blood flow, and reduced interdialytic weight gain.
- Further research is recommended to validate and implement these findings in clinical practice.
Background And Objective:
Patient activation is a concept that refers to the willingness to manage one's health and medical care. To assess it, a patient activation measure (PAM) has been developed and validated. Several studies report low activation in patients with chronic diseases. However, information on activation in hemodialysis patients is scarce. The aim of the present study is to describe the activation level of patients on chronic treatment in an HD unit and its relationship with disease control parameters.
Materials And Methods:
Cross-sectional observational study in patients with advanced chronic kidney disease on chronic HD treatment. Ninety-six patients were included. Activation was measured with the PAM-13 questionnaire. Its relationship with descriptive variables (age, sex, comorbidity, studies, habitat) and disease control variables (vascular access, blood flow, potassaemia, phosphataemia, interdialytic gain) was studied. For this purpose, Spearman's correlation test, multiple linear regression model and logistic model were used as statistical methods.
Results:
The mean (SD) PAM-13 score was 63.19 (15.21). Activation was significantly associated with vascular access (P = 0.003), blood flow (P = 0.024), and interdialytic gain of patients (P = 0.008).
Conclusions:
Activation in patients on chronic hemodialysis treatment is low. Higher activation is related having an arteriovenous fistula, higher blood flow and lower interdialytic gain. Future studies are needed to confirm and apply our results.
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