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Excerpt
Patients' life satisfaction is an important parameter in assessing outcomes of transplantation. The Transplant Learning Center (TLC) is a patient education tool designed to provide personalized feedback to adult solid-organ transplant recipients taking Neoral or Sandimmune. Patient responses to questionnaires provide the basis for feedback reports that are sent to the patient and his/her health care providers in quarterly "Cycles." Each report covers a topic of relevance to transplant recipients. In Cycle 1, enrollees were asked to rate their satisfaction levels with many aspects of their lives, including overall health, health care received, and relationships with others. These responses were incorporated into the Life Satisfaction Index (LSI). Purpose: To determine the factors that influence life satisfaction in the TLC population. Method: All TLC enrollees completing Cycle 1 were placed into three categories: low LSI, moderate LSI, and high LSI. Cross-tabulation analyses were performed to determine the influence of specific factors on enrollee LSI. Results: 1165 enrollees completed Cycle 1. The majority (63%) were between 1 and 5 years post-transplant; 28% >5 years and 9% <1 year. Overall, 84% of enrollees had a high LSI, 11% moderate LSI, and 5% low LSI. There was no association between LSI and the type of organ transplanted. Patients who are employed post-transplant had a significantly higher LSI. Married (or partnered) kidney recipients and older recipients of other organs also had a high LSI (p <0.05). The presence of side effects had a major negative impact on LSI. (For kidney recipients: body or face shape, headaches, and decreased sex interest; for other organ recipients: gum problems, easy bruising/slow healing). Higher LSI was found for those who, prior to completing Cycle 1, expressed no concerns about their ability to care for general health, ability to care for their transplant, ability to manage side effects, ability to be physically active, ability to pay for medical care, ability to communicate with others, their emotional state, or their appearance (p <0.05). The presence of arthritis or a greater total number of reported comorbidities were significantly associated with a lower LSI (p <0.05). Conclusion: For patients participating in the TLC program, life satisfaction is influenced by employment status, the presence of side effects, availability of spouse or partner, and patients' baseline concerns regarding several transplant-related issues. Strategies to address patient concerns and minimize side effects may substantially improve life satisfaction.
This research was funded by Novartis Pharmaceuticals Corporation.
