Social determinants of health impact patient views on care, life quality after transplant
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Certain social determinants of health impacted how patients viewed the care they received and their quality of life following kidney transplantation, according to research presented at the virtual ASN Kidney Week.
“Measuring and understanding patient-reported outcomes [PROs, eg, health-related quality of life (HRQoL) and satisfaction with transplant clinic service] is a critical consideration for the care of kidney transplant (KT)-eligible patients with end-stage renal disease, because research has demonstrated that pre-transplant HRQoL predicts both the receipt of a KT as well as post-KT mortality,” Samuel L. Swift, PhD, of the University of New Mexico, Albuquerque, and colleagues wrote in a poster. “Although research demonstrated the importance of social determinates of health (eg, cultural factors, psychosocial characteristics, transplant knowledge) on clinical outcomes, less is known about how they predict PRO in KT-eligible ESRD patients.”
For the study, researchers interviewed patients twice: once soon after initiating evaluation for transplant and again within 1 year of completing the evaluation. They assessed the impact of social determinants of health on PRO measures of HRQoL and satisfaction with kidney transplant clinic service.
They found “a stronger sense of mastery” over the social detriments of health predicted higher physical composite score, mental health composite score (MCS) and kidney summary score (KSS; from the kidney disease quality of life short form), whereas depression predicted lower MCS and lower KSS.
Regarding satisfaction with service at the transplant center, they found more medical mistrust predicted lower odds of higher patient satisfaction scores.
“Transplant teams should consider identifying and targeting patients with a low sense of mastery, greater depressive symptoms or an increased sense of medical mistrust, with additional psychosocial support to improve PRO during the KT evaluation process,” the researchers suggested.
Swift provided additional commentary on the results in a related press release.
“In our study, social determinants of health predicted patient-reported outcomes, suggesting that these factors are important for future research and intervention development,” he said. “Transplant teams can use knowledge of how these key social determinants of health predict patient-reported outcomes to improve the experience of patients with kidney failure undergoing transplant evaluation.”
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Swift SL, et al. Paper SU-OR43. Presented at: ASN Kidney Week. Oct. 22-25, 2020 (virtual meeting).
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