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Changes in quality of life, health status and other patient-reported outcomes following simultaneous pancreas and kidney transplantation (SPKT): a quantitative and qualitative analysis within a UK-wide programme.

Accepted version
Peer-reviewed

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Type

Article

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Authors

Bayfield, Janet 
Watson, Christopher JE 
Oniscu, Gabriel C 

Abstract

We examined quality of life (QoL) and other patient-reported outcome measures (PROMs) in 95 simultaneous pancreas and kidney transplant (SPKT) recipients and 41 patients wait-listed for SPKT recruited to the UK Access to Transplantation and Transplant Outcome Measures (ATTOM) programme. Wait-listed patients transplanted within 12 months of recruitment (n = 22) were followed 12 months post-transplant and compared with those still wait-listed (n = 19) to examine pre- to post-transplant changes. Qualitative interviews with ten SPKT recipients 12 months post-transplant were analysed thematically. Cross-sectional analyses showed several better 12-month outcomes for SPKT recipients compared with those still wait-listed, a trend to better health utilities but no difference in diabetes-specific QoL or diabetes treatment satisfaction. Pre- to post-transplant, SPKT recipients showed improved treatment satisfaction, well-being, self-reported health, generic QoL and less negative impact on renal-specific QoL (ps < 0.05). Health utility values were better overall in transplant recipients and neither these nor diabetes-specific QoL changed significantly in either group. Pre-emptive transplant advantages seen in 12-month cross-sectional analyses disappeared when controlling for baseline values. Qualitative findings indicated diabetes complications, self-imposed blood glucose monitoring and dietary restrictions continued to impact QoL negatively post-transplant. Unrealistic expectations of SPKT caused some disappointment. Measuring condition-specific PROMs over time will help in demonstrating the benefits and limitations of SPKT.

Description

Keywords

diabetes, kidney transplant, patient-reported outcome measures (PROMs), quality of life, renal, simultaneous pancreas, simultaneous pancreas and kidney transplantation, transplantation, Blood Glucose, Blood Glucose Self-Monitoring, Cross-Sectional Studies, Health Status, Humans, Kidney Transplantation, Pancreas, Pancreas Transplantation, Patient Reported Outcome Measures, Quality of Life, United Kingdom

Journal Title

Transpl Int

Conference Name

Journal ISSN

0934-0874
1432-2277

Volume Title

33

Publisher

Frontiers Media SA

Rights

All rights reserved
Sponsorship
National Institute for Health and Care Research (RP-PG-0109-10116)