Health-related quality of life in adults receiving home parenteral nutrition: A multi-centre cross-sectional study.
No Thumbnail Available
All Authors
Kirk, C.
Pearce, MS.
Jones, DE.
Thompson, NP.
Mooney, PD.
Dibb, M.
Mathers, JC.
LTHT Author
Mooney, Peter
LTHT Department
Abdominal Medicine & Surgery
Gastroenterology
Gastroenterology
Non Medic
Publication Date
2026
Item Type
Journal Article
Language
Subject
TREATMENT OUTCOME , QUALITY OF LIFE , PARENTERAL NUTRITION, HOME
Subject Headings
Abstract
BACKGROUND & AIMS: Home parenteral nutrition (HPN) is life-sustaining for chronic intestinal failure; however, both intestinal failure itself and the demands of long-term HPN are associated with symptoms, complications and treatment burden that may impair quality of life. This study evaluated health-related QoL (HRQoL) in adults receiving long-term HPN and examined associations with sociodemographic, clinical, biochemical and nutritional factors.
METHODS: Baseline data were analysed from a prospective multicentre cohort study across three UK HPN centres. Adults (>=18 years) receiving HPN for benign disease completed the EuroQol-5D-5L (EQ-5D-5L) and Short Form-36 (SF-36) questionnaires. Clinical, sociodemographic, anthropometric and nutritional data were collected. Associations between HRQoL outcomes and candidate predictors were examined using univariate and multivariable regression.
RESULTS: One hundred and eighty-three participants were analysed (median age 61 years; 64 % female). Median EQ-5D-5L utility and EQ-VAS scores were 0.49 (IQR 0.22-0.67) and 50 (40-70), respectively. SF-36 scores were markedly impaired across all domains, with lowest medians for physical functioning, role limitations, energy/fatigue and general health (0-30). In multivariable models, higher phase angle independently predicted better role limitations due to physical health (beta 13.93, 95 % CI 1.13-26.72; p = 0.035; R2 = 0.53). Greater handgrip strength was associated with higher energy/fatigue scores (beta 0.62, 95 % CI 0.18-1.06; p = 0.007; R2 = 0.25). Employment was strongly associated with emotional wellbeing (employed vs unemployed; beta 19.19, 95 % CI 9.13-29.26; p < 0.001; R2 = 0.21) and general health (beta 20.49, 95 % CI 10.66-30.32; p < 0.001; R2 = 0.14). Higher oral dietary energy intake was associated with better social functioning (beta 0.02, 95 % CI 0.01-0.03; p < 0.001). Underlying diagnosis, small bowel length and HPN macronutrient composition showed no consistent relationships.
CONCLUSION: Adults receiving long-term HPN experience profound impairment in HRQoL, comparable with other high-burden chronic diseases. Variation in QoL was more strongly related to employment, education, muscle strength, oral intake and treatment burden than to diagnosis or HPN composition, highlighting modifiable targets for multidisciplinary care.
Journal
Clinical Nutrition ESPEN