Quality of Life in the Management of Home Parenteral Nutrition

Ann Nutr Metab. 2023;79(3):326-333. doi: 10.1159/000530082. Epub 2023 Mar 17.

Abstract

Introduction: Home parenteral nutrition (HPN) is a rare but challenging therapy for patients with mostly severe underlying diseases. We aimed to investigate patient-reported health-related quality of life (QOL) of patients receiving HPN and its development over time in particular.

Methods: We assessed QOL of HPN patients in a prospective multicenter observational study (SWISSHPN II study). We designed a questionnaire to record symptoms and negative impacts of HPN and completed the validated Optum® SF-36v2® Health Survey with the patients.

Results: Seventy patients (50% women) on HPN were included. HPN commonly affected feelings of dependency (n = 49, 70%), traveling/leaving home (n = 37, 53%), attending cultural and social events (n = 25, 36%), and sleep (n = 22, 31%). Most frequently reported symptoms were diarrhea (n = 30, 43%), polyuria (n = 28, 40%), nausea/emesis (n = 27, 39%), dysgeusia (n = 23, 33%), and cramps (n = 20, 29%). At baseline, mean (standard deviation) SF-36v2® physical and mental health component summary scores (PCS and MCS) were 45 (20) and 57 (19), respectively, and there was a trend toward improvement in PCS over the study period, while MCS remained stable. Satisfaction with health care professionals involved in HPN care was high.

Conclusion: QOL is a crucial and decisive aspect of HPN patient care. Symptoms related to the underlying disease and PN are frequent. Impaired social life and an ambivalent attitude toward the life-saving therapy are major concerns for these patients and should be addressed in their care.

Keywords: Home parenteral nutrition; Parenteral nutrition; Patient-reported outcomes; Quality of life; SF-36v2.

Publication types

  • Observational Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Female
  • Health Surveys
  • Humans
  • Male
  • Parenteral Nutrition, Home*
  • Prospective Studies
  • Quality of Life*
  • Surveys and Questionnaires

Grants and funding

This research was funded by a third party grant of the Division of Clinical Pharmacy and Epidemiology, University of Basel, grant number FO119900, and the Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital, Bern University Hospital, research fund number WFE-012.