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A4925 - Quality of Life After Lung Transplant
Author Block: J. D. Johnson1, P. Hutchison2; 1Pulmonary and Critical Care Medicine, Loyola University Medical Center, Maywood, IL, United States, 2Pulmonary and Critical Care, Loyola University Medical Center, Maywood, IL, United States.
RATIONALE:
Despite a growing interest in the field of palliative care as it relates to advanced lung disease, the application of palliative philosophies and practices has been largely unexplored in lung transplant patients. These patients frequently encounter post transplant complications including rejection, infections, and repeat hospitalizations and procedures. There is a growing need for interventions addressing quality of life (QOL) in this population. We hypothesized that increased attention to QOL issues through a 5-point checklist on daily rounds can increase QOL interventions and patients’ perceived quality of life.
METHODS:
A before-and-after design was used to assess the effectiveness of our checklist. Inclusion criteria included lung transplant greater than one-month prior and admission to the lung transplant inpatient service at Loyola University Medical Center. All patients completed the Rand SF-36 survey at the time of admission and discharge. The control group was surveyed first to limit bias that would be introduced through simultaneous enrollment of control and intervention patients. After the control sample was surveyed, the intervention was implemented on subsequently admitted lung transplant patients. In this group, the pulmonary fellow or nurse practitioner on the team implemented a 5-point checklist on daily rounds addressing appetite, sleep, mood, functional status, and social functioning. Interventions based on the results were left to the discretion of the primary team. The interventions were charted in the daily progress note to ensure completion of the checklist. Our primary outcome was a change in SF-36 results. The secondary outcome was the number of interventions based on checklist results.
RESULTS/CONCLUSIONS:
Preliminary data demonstrate RAND SF-36 scores in the control group to be lowest in the categories of “General Health” and “Limitations from Physical Health” with averages of 39 and 13 (out of 100) respectively with no significant change at discharge in any category. These results are comparable to published data of patients with advanced lung disease prior to transplant. The average number of checklist interventions per control patient was less than 1. The intervention group averages are similarly low with lowest scores in the categories of “Limitations from Physical Health” and “Energy” at 0 and 16.25 on admission and discharge. The number of checklist interventions average 2 per patient. We believe the data to be valuable regardless of outcomes as it samples quality of life at varying stages post transplant where the limited older studies focus on the initial post transplant period.