Original InvestigationDialysisTravel Time to Dialysis as a Predictor of Health-Related Quality of Life, Adherence, and Mortality: The Dialysis Outcomes and Practice Patterns Study (DOPPS)
Section snippets
Study Sample
This study used a sample of 20,994 hemodialysis patients from the Dialysis Outcomes and Practices Patterns Study (DOPPS I, 10,775 patients; DOPPS II, 10,219 patients) who completed a patient questionnaire. These prospective observational studies involve adult hemodialysis patients randomly selected from 307 representative dialysis facilities in 7 countries (France, Germany, Italy, Japan, Spain, United Kingdom, and United States) for DOPPS I and 319 dialysis facilities in 12 countries (DOPPS I
Results
Of 28,323 DOPPS patients, 25.9% did not complete the patient questionnaire and thus were ineligible for this study. Table 1 lists the distribution of patient characteristics for the study population by travel time and for those who did not complete the patient questionnaire. Ineligible nonresponders were significantly older, more likely to be black, had a greater prevalence of several comorbid conditions, had a shorter time since starting dialysis therapy, and were less likely to be employed,
Discussion
In this large international study, longer travel time to dialysis therapy was associated with lower HR-QOL and a significantly greater risk of mortality. These observations remained large and significant after controlling for possible confounders and in all sensitivity analyses. Furthermore, problems with transportation contributing to both skipped and shortened treatments were more common in those with the longest travel times. These results highlight travel time as a potentially modifiable
Acknowledgements
This report was edited by Caroline Shevrin, MS, of the Arbor Research Collaborative for Health.
Support: The DOPPS is supported by research grants from Amgen Inc and Kirin Pharma Co Ltd, without restrictions on publications.
Financial Disclosure: None.
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Originally published online as doi:10.1053/j.ajkd.2007.12.021 on February 27, 2008.