Analysis of potential categories and influencing factors of chronic comorbidity treatment burden in maintenance hemodialysis patients_West China Medical Journal

Authors：

XU Jun ¹ , JI Xiaojing ¹ , DAI Huanhuan ¹ , YU Xintao ¹ ,  GONG Aiping ¹ , GUO Suping ¹ , JIANG Lu ²

1. Blood Purification Center, Northern Jiangsu People’s Hospital, Yangzhou, Jiangsu 225000, P. R. China;
2. Blood Purification Center, Jiangdu People’s Hospital, Yangzhou, Jiangsu 225202, P. R. China;

Corresponding author：

GONG Aiping, Email: 515636728@qq.com

Keywords：

Maintenance hemodialysis; comorbidity; treatment burden; latent class analysis; influencing factor

DOI：

10.7507/1002-0179.202307081

Video：

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Objective To explore the potential categories and influencing factors of chronic comorbidity treatment burden in maintenance hemodialysis (MHD) patients. Methods Convenience sampling method was used to select MHD patients between April and May 2023 at Northern Jiangsu People’s Hospital and Jiangdu People’s Hospital as the research subjects. The general information questionnaire, Chronic Disease Comorbidity Treatment Burden Scale, and Health Literacy Scale for Chronic Disease Patients were used for the questionnaire survey. The latent class analysis was used to explore the classification of chronic comorbidity treatment burden in MHD patients, and the multi-class logistic regression analysis was used to explore the influencing factors of comorbidity treatment burden. Results A total of 450 survey questionnaires were distributed, and 406 valid questionnaires were collected, with an effective response rate of 90.22%. According to the latent class analysis results, the comorbidity treatment burden of MHD patients was divided into three potential categories. Among them, there were 26 cases in the low-burden group, 194 cases in the medium-burden group, and 186 cases in the high-burden group. The results of the ordered multi-class logistic regression analysis showed that patient age, educational level, dialysis age, number of comorbidities, and level of economic support were potential factors affecting the comorbidity treatment burden in MHD patients (P<0.05). Conclusions The comorbidity treatment burden of MHD patients can be divided into three potential categories. The age, educational level, dialysis age, number of comorbidities, and level of economic support of patients are potential factors affecting the comorbidity treatment burden in MHD patients.

Citation： XU Jun, JI Xiaojing, DAI Huanhuan, YU Xintao, GONG Aiping, GUO Suping, JIANG Lu. Analysis of potential categories and influencing factors of chronic comorbidity treatment burden in maintenance hemodialysis patients. West China Medical Journal, 2024, 39(8): 1252-1258. doi: 10.7507/1002-0179.202307081 Copy

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2.	World Health Organization. The world health report 2008. Primary health cared now more than ever. New York: World Health Organization, 2008.
3.	王静, 张灿, 田瑞杰. 中青年住院慢性肾脏病患者共病模式分析. 中华现代护理杂志, 2022, 28(23): 3117-3122.
4.	Chang AY, Bryazka D, Dieleman JL. Estimating health spending associated with chronic multimorbidity in 2018: an observational study among adults in the United States. PLoS Med, 2023, 20(4): e1004205.
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6.	陈晔, 宋秀娟, 陈倍倍, 等. 温州地区老年期痴呆合并慢性病患者治疗负担的调查研究. 中国卫生统计, 2022, 39(3): 393-396.
7.	唐源, 李潘, 何咏梅, 等. 老年慢性病共存患者治疗负担与健康素养的相关性研究. 卫生职业教育, 2023, 41(7): 108-111.
8.	曾宪华, 肖琳, 张岩波. 潜在类别分析原理及实例分析. 中国卫生统计, 2013, 30(6): 815-817.
9.	Davies SJ, Phillips L, Naish PF, et al. Quantifying comorbidity in peritoneal dialysis patients and its relationship to other predictors of survival. Nephrol Dial Transplant, 2002, 17(6): 1085-1092.
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11.	孙浩林, 彭慧, 傅华. 慢性病患者健康素养量表信效度的研究. 复旦学报(医学版), 2012, 39(3): 268-272.
12.	王孟成. 潜变量建模与 Mplus 应用·进阶篇. 重庆: 重庆大学出版社, 2018: 2-33.
13.	吴一平, 黄燕林, 杨洁, 等. 维持性血液透析病人慢性病共病治疗负担研究进展. 护理研究, 2022, 36(17): 3085-3090.
14.	Dufour S, Banaag A, Schoenfeld AJ, et al. Diagnostic profiles associated with long-term opioid therapy in active duty servicemembers. PM R, 2024, 16(1): 14-24.
15.	Blum M, McKendrick K, Gelfman LP, et al. Using latent class analysis to identify different clinical profiles among patients with advanced heart failure. J Pain Symptom Manage, 2023, 65(2): 111-119.
16.	Duncan P, Murphy M, Man MS, et al. Development and validation of the Multimorbidity Treatment Burden Questionnaire (MTBQ). BMJ Open, 2018, 8(4): e019413.
17.	Ismail S, Stanley A, Jeemon P. Prevalence of multimorbidity and associated treatment burden in primary care settings in Kerala: a cross-sectional study in Malappuram District, Kerala, India. Wellcome Open Res, 2022, 7: 67.
18.	Zelenak C, Nagel J, Bersch K, et al. Integrated care for older multimorbid heart failure patients: protocol for the ESCAPE randomized trial and cohort study. ESC Heart Fail, 2023, 10(3): 2051-2065.
19.	Benjamin RM. Multiple chronic conditions: a public health challenge. Public Health Rep, 2010, 125(5): 626-627.
20.	龙治巧, 常立阳, 郑雨鹃. 老年血液透析病人慢性共病状态研究进展. 护理研究, 2024, 38(4): 656-661.
21.	Schulze J, Breckner A, Duncan P, et al. Adaptation and validation of a German version of the Multimorbidity Treatment Burden Questionnaire. Health Qual Life Outcomes, 2022, 20(1): 90.
22.	Guénette L, Turcotte V, Bélanger L, et al. Multimorbidity Treatment Burden Questionnaire (MTBQ): translation, cultural adaptation, and validation in French-Canadian. Can J Aging, 2023, 42(1): 126-134.
23.	Al-Mansouri A, Hamad AI, Al-Ali FS, et al. Pill-burden and its association with treatment burden among patients with advanced stages of chronic kidney disease. Saudi Pharm J, 2023, 31(5): 678-686.
24.	Altabee R, Carr SB, Abbott J, et al. Exploring the nature of perceived treatment burden: a study to compare treatment burden measures in adults with cystic fibrosis [version 1; peer review: 2 approved]. NIHR Open Res, 2022, 2: 36.
25.	Sav A, McMillan SS, Kelly F, et al. Treatment burden among people with chronic illness: what are consumer health organizations saying?. Chronic Illn, 2013, 9(3): 220-232.
26.	van Pinxteren M, Mbokazi N, Murphy K, et al. The impact of persistent precarity on patients’ capacity to manage their treatment burden: a comparative qualitative study between urban and rural patients with multimorbidity in South Africa. Front Med (Lausanne), 2023, 10: 1061190.
27.	Pedersen MH, Duncan P, Lasgaard M, et al. Danish validation of the Multimorbidity Treatment Burden Questionnaire (MTBQ) and findings from a population health survey: a mixed-methods study. BMJ Open, 2022, 12(1): e055276.

1. Al-Mansouri A, Al-Ali FS, Hamad AI, et al. Assessment of treatment burden and its impact on quality of life in dialysis-dependent and pre-dialysis chronic kidney disease patients. Res Social Adm Pharm, 2021, 17(11): 1937-1944.
2. World Health Organization. The world health report 2008. Primary health cared now more than ever. New York: World Health Organization, 2008.
3. 王静, 张灿, 田瑞杰. 中青年住院慢性肾脏病患者共病模式分析. 中华现代护理杂志, 2022, 28(23): 3117-3122.
4. Chang AY, Bryazka D, Dieleman JL. Estimating health spending associated with chronic multimorbidity in 2018: an observational study among adults in the United States. PLoS Med, 2023, 20(4): e1004205.
5. 豆丽园, 黄娟, 叶森, 等. 社区老年慢性病共存患者治疗负担现状及影响因素研究. 中国全科医学, 2021, 24(13): 1671-1675.
6. 陈晔, 宋秀娟, 陈倍倍, 等. 温州地区老年期痴呆合并慢性病患者治疗负担的调查研究. 中国卫生统计, 2022, 39(3): 393-396.
7. 唐源, 李潘, 何咏梅, 等. 老年慢性病共存患者治疗负担与健康素养的相关性研究. 卫生职业教育, 2023, 41(7): 108-111.
8. 曾宪华, 肖琳, 张岩波. 潜在类别分析原理及实例分析. 中国卫生统计, 2013, 30(6): 815-817.
9. Davies SJ, Phillips L, Naish PF, et al. Quantifying comorbidity in peritoneal dialysis patients and its relationship to other predictors of survival. Nephrol Dial Transplant, 2002, 17(6): 1085-1092.
10. 许腾. 基于累积复杂模型老年慢性病共病患者治疗负担的影响因素研究. 延边: 延边大学, 2022.
11. 孙浩林, 彭慧, 傅华. 慢性病患者健康素养量表信效度的研究. 复旦学报(医学版), 2012, 39(3): 268-272.
12. 王孟成. 潜变量建模与 Mplus 应用·进阶篇. 重庆: 重庆大学出版社, 2018: 2-33.
13. 吴一平, 黄燕林, 杨洁, 等. 维持性血液透析病人慢性病共病治疗负担研究进展. 护理研究, 2022, 36(17): 3085-3090.
14. Dufour S, Banaag A, Schoenfeld AJ, et al. Diagnostic profiles associated with long-term opioid therapy in active duty servicemembers. PM R, 2024, 16(1): 14-24.
15. Blum M, McKendrick K, Gelfman LP, et al. Using latent class analysis to identify different clinical profiles among patients with advanced heart failure. J Pain Symptom Manage, 2023, 65(2): 111-119.
16. Duncan P, Murphy M, Man MS, et al. Development and validation of the Multimorbidity Treatment Burden Questionnaire (MTBQ). BMJ Open, 2018, 8(4): e019413.
17. Ismail S, Stanley A, Jeemon P. Prevalence of multimorbidity and associated treatment burden in primary care settings in Kerala: a cross-sectional study in Malappuram District, Kerala, India. Wellcome Open Res, 2022, 7: 67.
18. Zelenak C, Nagel J, Bersch K, et al. Integrated care for older multimorbid heart failure patients: protocol for the ESCAPE randomized trial and cohort study. ESC Heart Fail, 2023, 10(3): 2051-2065.
19. Benjamin RM. Multiple chronic conditions: a public health challenge. Public Health Rep, 2010, 125(5): 626-627.
20. 龙治巧, 常立阳, 郑雨鹃. 老年血液透析病人慢性共病状态研究进展. 护理研究, 2024, 38(4): 656-661.
21. Schulze J, Breckner A, Duncan P, et al. Adaptation and validation of a German version of the Multimorbidity Treatment Burden Questionnaire. Health Qual Life Outcomes, 2022, 20(1): 90.
22. Guénette L, Turcotte V, Bélanger L, et al. Multimorbidity Treatment Burden Questionnaire (MTBQ): translation, cultural adaptation, and validation in French-Canadian. Can J Aging, 2023, 42(1): 126-134.
23. Al-Mansouri A, Hamad AI, Al-Ali FS, et al. Pill-burden and its association with treatment burden among patients with advanced stages of chronic kidney disease. Saudi Pharm J, 2023, 31(5): 678-686.
24. Altabee R, Carr SB, Abbott J, et al. Exploring the nature of perceived treatment burden: a study to compare treatment burden measures in adults with cystic fibrosis [version 1; peer review: 2 approved]. NIHR Open Res, 2022, 2: 36.
25. Sav A, McMillan SS, Kelly F, et al. Treatment burden among people with chronic illness: what are consumer health organizations saying?. Chronic Illn, 2013, 9(3): 220-232.
26. van Pinxteren M, Mbokazi N, Murphy K, et al. The impact of persistent precarity on patients’ capacity to manage their treatment burden: a comparative qualitative study between urban and rural patients with multimorbidity in South Africa. Front Med (Lausanne), 2023, 10: 1061190.
27. Pedersen MH, Duncan P, Lasgaard M, et al. Danish validation of the Multimorbidity Treatment Burden Questionnaire (MTBQ) and findings from a population health survey: a mixed-methods study. BMJ Open, 2022, 12(1): e055276.

West China Medical Journal

Analysis of potential categories and influencing factors of chronic comorbidity treatment burden in maintenance hemodialysis patients

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