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Psychosocial impact and residual resource needs following institution of enzyme substitution therapy for PKU

Sprague, Trinity (2021) Psychosocial impact and residual resource needs following institution of enzyme substitution therapy for PKU. Master's Thesis, University of Pittsburgh. (Unpublished)

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Abstract

Background: Phenylketonuria (PKU) is one of the most common inherited metabolic disorders and the first to be included on newborn screening. Even treated, it can impact quality of life (QoL) due to strict dietary management and potential for neuropsychiatric symptoms including anxiety, depression, and impaired executive functioning and attention. This study aims to learn about the impact the newest treatment for PKU – pegvaliase, an enzyme substitution therapy – has on QoL and to assess the residual support and resource needs of patients taking it. In clinical trials, pegvaliase was shown to improve certain neuropsychiatric symptoms. No research is currently published on the impact of pegvaliase on overall QoL or residual support and resource needs.
Methods: Adults who have PKU were surveyed, including adults who are and are not taking pegvaliase. Survey questions assessed current management, overall QoL, QoL PKU-related, and currently utilized resources and supports and remaining needs. Standardized questions assessing depression and cognition were also included. Responses were compared by whether the respondent was taking pegvaliase and whether their phe levels were above or below a set threshold.
Results: Significant differences were found in satisfaction with management, impact of PKU, general satisfaction with life, and cognition when comparing by phe level. When comparing by pegvaliase status, a significant difference was only found in satisfaction with management. Residual resource and support needs predominantly involved social, financial, and adult-specific needs, although many respondents reported utilizing supports or resources in these domains.
Conclusions: The knowledge gained by this study is relevant to public health and genetic counseling by adding to the existing literature on QoL related to PKU, specifically related to use of pegvaliase and phe levels. Phe level seemed to have the most robust impact on QoL, although pegvaliase use was shown to improve QoL to a degree – likely related to its ability to lower phe levels. PKU-related worries seem to have a similar impact on QoL regardless of management, and should be a focus for future care. Ensuring that adult patients are aware of available supports and resources is also important in filling residual needs reported in this study.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Sprague, Trinitytrs106@pitt.edutrs106
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairWalsh Vockley, Catherinecatherine.walshvockley@chp.edu
Committee MemberGrubs, Robinrgrubs@pitt.edurgrubs
Committee MemberBear, Toddtobst2@pitt.edutobst2
Committee MemberMelissa, Sutcliffesternmk@umpc.edu
Date: 12 May 2021
Date Type: Publication
Defense Date: 30 March 2021
Approval Date: 12 May 2021
Submission Date: 27 April 2021
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 148
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Genetic Counseling
Degree: MS - Master of Science
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: PKU, Quality of Life, Pegvaliase, Resource needs, Support needs, Adults
Date Deposited: 13 May 2021 01:49
Last Modified: 13 May 2021 01:49
URI: http://d-scholarship.pitt.edu/id/eprint/40887

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  • Psychosocial impact and residual resource needs following institution of enzyme substitution therapy for PKU. (deposited 13 May 2021 01:49) [Currently Displayed]

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