J Jackson

Cross-sectional survey in CKD patients across Europe describing the association between quality of life and anaemia

BackgroundDeteriorating renal function in chronic kidney disease (CKD) patients is commonly associated with reduced haemoglobin levels, adding to the already considerable humanistic burden of CKD. This analysis evaluated the impact of anaemia on disease burden in patients with CKD stages 3–4, and in those on dialysis.MethodsThis was a descriptive, cross-sectional analysis of European data from an Adelphi CKD Disease-Specific Programme. This programme collected data from patients and their treating nephrologists/endocrinologists; patient- and physician-reported data were matched for each patient. Health-related quality of life (HRQoL) data were obtained through patient completion of the EQ-5D, SF-12 and KDQOL-36. Additional information was obtained via physician reporting of patient symptoms, and patients’ reports of impaired activity. Anaemia was defined by haemoglobin level and/or current use of erythropoiesis stimulating agents.ResultsSignificant, but modest Spearman’s rank correlations were observed between haemoglobin levels and extent of HRQoL impairment, regardless of instrument used (range 0.19–0.23; all P-valuesu2009<u20090.0001). When stratified by anaemia status, impairment was consistently lower for anaemic than non-anaemic CKD patients across measurement scales (e.g. EQ-5D index value [standard deviation {SD}] 0.72 [0.31] vs 0.83 [0.23], respectively; Pu2009<u20090.0001). Physician-reported patient tiredness was associated with increased disease burden at all levels of CKD studied (total EQ-5D index value [SD] in patients reporting no tiredness vs tiredness 0.81 [0.26] vs 0.70 [0.30] respectively; Pu2009<u20090.0001) with Pu2009<u20090.0001 for no tiredness vs tiredness at all stages of CKD. The presence of anaemia was associated with impaired activity levels at CKD stages 3 (37.5xa0% vs 28.4xa0%, respectively; Pu2009=u20090.0044) and 4 (48.1xa0% vs 39.9xa0%, respectively; Pu2009=u20090.0292), and in patients on dialysis (52.0xa0% vs 45.0xa0%, respectively; Pu2009=u20090.0732).ConclusionsThe analysis found that CKD patients with anaemia typically had a lower HRQoL than those without anaemia. The impairment correlated with anaemia was more apparent in non-dialysis patients with CKD stages 3 or 4 than in those receiving dialysis. Coexisting CKD and anaemia may have an impact on patient HRQoL similar to other chronic conditions such as diabetes, epilepsy or certain forms of cancer.

Real-World Impact of Cardiovascular Disease and Anemia on Quality of Life and Productivity in Patients with Non-Dialysis-Dependent Chronic Kidney Disease

IntroductionPatients with chronic kidney disease (CKD) have an increased risk of comorbid conditions, including cardiovascular disease (CVD). Anemia is prevalent in the CKD population and worsens as kidney function declines, resulting in a diminished quality of life and increased morbidity/mortality. The purpose of this secondary analysis was to determine the real-world prevalence of CVD among patients with non-dialysis-dependent CKD (NDD-CKD), with and without comorbid anemia, and to assess the impact of these conditions on quality of life (QoL) and work productivity.MethodsData were drawn from the Adelphi CKD Disease-Specific Programme, conducted in France, Germany, Italy, Spain, and the UK (2012). Anonymized data were collected via patient record forms and patient-completed questionnaires. Patient data were stratified by anemic status and the presence of CVD comorbidity.ResultsData were collected by physicians for 1993 patients, of whom 867 completed a patient-completed questionnaire. A total of 61.4% of patients had anemia, and the prevalence of anemia increased with CKD stage. Patients with anemia had a higher mean number of cardiovascular comorbidities than non-anemic patients (1.27 vs 0.95, respectively; Pxa0<xa00.001). The presence of cardiovascular conditions was associated with a significantly reduced QoL (EuroQol EQ-5D-3L visual analog scale: coefficient, −5.68 in anemic patients; Pxa0=xa00.028) and work productivity and activity impairment (WPAI activity impairment: coefficient, +8.04 in anemic patients; Pxa0=xa00.032), particularly among anemic patients.ConclusionsThe presence of anemia in this cohort of NDD-CKD patients was high. The presence of concomitant cardiovascular conditions was more common in NDD-CKD patients with comorbid anemia, and was associated with reduced QoL and work productivity outcomes.

A Real-World Analysis of Migraine: A Cross-Sectional Study of Disease Burden and Treatment Patterns

The purpose of this cross‐sectional study was to assess the sociodemographics, disease burden, and treatment patterns of patients with episodic and chronic migraine in the United States.

Burden of heart failure on patients from China: results from a cross-sectional survey

Purpose Little evidence exists on the burden that chronic heart failure (HF) poses specifically to patients in China. The objective of this study, therefore, was to describe the burden of HF on patients in China. Materials and methods A cross-sectional survey of cardiologists and their patients with HF was conducted. Patient record forms were completed by 150 cardiologists for 10 consecutive patients. Patients for whom a patient record form was completed were invited to complete a patient questionnaire. Results Most of the 933 patients (mean [SD] age 65.8 [10.2] years; 55% male; 80% retired) included in the study received care in tier 2 and 3 hospitals in large cities. Patients gave a median score of 4 on a scale from 1 (no disruption) to 10 (severe disruption) to describe how much HF disrupts their everyday life. Patients in paid employment (8%) missed 10% of work time and experienced 29% impairment in their ability to work due to HF in the previous week. All aspects of patients’ health-related quality of life (QoL) were negatively affected by their condition. Mean ± SD utility calculated by the 3-level 5-dimension EuroQol questionnaire was 0.8±0.2, and patients rated their health at 70.3 (11.5) on a 100 mm visual analog scale. Patients incurred costs associated with HF treatment, travel, and professional caregiving services. Conclusion HF is associated with poor health-related QoL and considerable disruption in patients’ lives. Novel and improved therapies are needed to reduce the burden of HF on patients and the health care system.

Burden of heart failure on caregivers in China: results from a cross-sectional survey

Purpose Family and friends play a pivotal role in caring for patients with heart failure (HF); however, evidence of the impact of caregiving is limited. The objectives of this study were to describe the burden of caregiving on informal caregivers of patients with chronic HF in China. Materials and methods A cross-sectional survey of cardiologists, their patients with HF, and those patients’ caregivers was conducted. Patient record forms were completed by 150 cardiologists for 10 consecutive patients. Caregivers of these patients were invited to complete a questionnaire. Results Overall, 458 caregivers completed a questionnaire (mean ± standard deviation age 60.1±10.6 years; 60% female; 77% spouses; 74% retired). Caregivers spent a mean of 24.5 (16.9) hours caregiving per week, and a third reported a reduction in their social activity, time for themselves, or time for family. Caregivers in employment took several days off work in the past 3 months owing to caregiving, sometimes resulting in reduced income. Up to 79% of caregivers reported an impact on their physical or emotional well-being, and 57% reported deterioration in their objective health status. Inconsistencies stemming from differences in the three-level five-dimension EuroQol questionnaire and HF Caregiver Questionnaire were observed for the impact of caregiving on caregivers’ health-related quality of life. Conclusion Assisting patients with HF is associated with caregiver burden. Addressing the needs of caregivers may help to promote their continued support and improve patient outcomes.

A cross-national study of augmentation of cholinesterase inhibitors with memantine in Alzheimer's disease

fields have been discovered. Methods: Subchronic effect of a weak combined magnetic field (MF), produced by superimposing a constant component (region mT) and an alternating MF of (0.1 mT) which was the sum of signals of frequencies region Hz, was studied in olfactory bulbectomized and transgenic B6aC3-Tg (APPswe, PSEN1DeltaE9) 85DBO/J mice, which were used as animal models of sporadic and heritable Alzheimer’s disease accordingly. Exposure to the MFs induced the decrease of Ab level in bulbectomized mice and reduced the number of Ab plaques in the cortex and hippocampus. Results: Positive results were obtained in volunteers with Alzheimer’s desease.We have developed several types of equipment for correction and treatment of their condition. Conclusions: We expect that numerous positive pieces of evidence both in animal experience and with humans will be of enormous importance for those suffering from different stages of Alzheimer’s desease all over the world.

A cross-national study of carer burden in dementia

Background: Laminaria japonica , an edible brown seaweed, has long been utilized since ancient times as an important food resource to promote maternal health in Pacific and Asian countries. Due to its high contents of dietary fiber, minerals, carbohydrates, and protein, L. japonica has recently attracted much attention for its bioactive materials and nutraceutical qualities. Methods: The present study examined the effects of desalted Laminaria japonica (D LJ) on learning and memory function and cholinergic neuron activity in trimethyltin (TMT) induced memory deficits rats.After TMT injection (8mg/kg, i.p.), rats were administered with saline or D LJ (10 and 50mg/kg, p.o.) daily for 21 days. The cognitive improving effects of D LJ on TMT-induced amnesic rats were investigated by assessing the Morris water maze test and by performing choline acetyltransferase (ChAT) immunohistochemistry.Results: In theMorris water maze, TMT treated group produced impairment in escape latency to find the platform. However, DLJ treated groups were significantly recovered the impairment of memory compared to the control group (on the 2nd and 4th day (P <0.05)). Consistent with behavioral data, DLJ group was significantly increased ChAT-ir neurons in the midial striatum compared to the control group (P <0.01). Conclusions: In conclusion, administration of D LJ improved spatial learning and memory. These results suggest that D LJ may be useful for the cognitive improvement via regulation of cholinergic marker enzyme activity.