Follow-Up Study on the Effect of Cognitive Behaviour Therapy on Haemodialysis Adherence

Valsaraj, Blessy Prabha; Bhat, Smitha; Prabhu, Ravindra; Kamath, Asha

doi:10.18295/squmj.2021.21.01.008

Cited by 8 publications

(5 citation statements)

References 32 publications

(46 reference statements)

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“…Surprisingly, years of dialysis and total Beck Depression Inventory-II (BDI-II) scores were found to be negatively associated; the more years a patient spent on dialysis, the fewer depressive symptoms experienced [ 42 ]. Other forms of therapy such as the cognitive behavior therapy that focuses on eliciting positive behavioral changes and encouraging emotional regulation have been illustrated to increase patients' adherence to dialysis, medication, and diet that ultimately improve the trajectory of their treatment [ 98 ]. In evaluating patients diagnosed with early stage of CKD (stages 1–3), depression was found to be linked to pain interference (measure of the extent pain impacts daily life), illness perception, and self-esteem, which are determining factors for depression [ 35 ].…”

Section: Resultsmentioning

confidence: 99%

Frailty and Age-Associated Assessments Associated with Chronic Kidney Disease and Transplantation Outcomes

Fulinara

Huynh

Goldwater

et al. 2023

Journal of Transplantation

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Background. Frailty is often defined as a decrease in physiological reserve and has been shown to be correlated with adverse health outcomes and mortality in the general population. This condition is highly prevalent in the chronic kidney disease (CKD) patient population as well as in kidney transplant (KT) recipients. Other age-associated changes include sarcopenia, nutrition, cognition, and depression. In assessing the contributions of these components to patient outcomes and their prevalence in the CKD and KT patient population, it can be determined how such variables may be associated with frailty and the extent to which they may impact the adverse outcomes an individual may experience. Objectives. We sought to perform a systematic literature review to review published data on frailty and associated age-associated syndromes in CKD and KT patients. Results. Over 80 references pertinent to frailty, sarcopenia, nutrition, cognition, or depression in patients with CKD or KT were identified. Systematic review was performed to evaluate the data supporting the use of the following approaches: Fried Frailty, Short Physical Performance Battery, Frailty Index, Sarcopenia Index, CT scan quantification of muscle mass, health-related quality of life, and assessment tools for nutrition, cognition, and depression. Conclusion. This report represents a comprehensive review of previously published research articles on this topic. The intersectionality between all these components in contributing to the patient’s clinical status suggests a need for a multifaceted approach to developing comprehensive care and treatment for the CKD and KT population to improve outcomes before and after transplantation.

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Section: Resultsmentioning

confidence: 99%

Frailty and Age-Associated Assessments Associated with Chronic Kidney Disease and Transplantation Outcomes

Fulinara

Huynh

Goldwater

et al. 2023

Journal of Transplantation

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“…In the study by Bellomo et al, IDWG changed from baseline to 6 months; in controls it ranged from 1.31 ± 0.33 to 1.32 ± 0.32 kg (P = 0.57) and in the treatment group it decreased from 1.33 ± 0.33 to 1.2 ± 0.28 kg (P < 0.001) [41]. In the study by Valsaray et al, the IDWG changed from baseline to 6 months; in controls it went from 4.3 ± 0.7 to 4.6 ± 0.4 kg (P = 0.856) and in the treatment group it dropped from 4.4 ± 0.9 to 3.2 ± 0.6 kg (P = 0.001) [44].…”

Section: Psychological/affective Interventionsmentioning

confidence: 88%

“…As no significant heterogeneity was observed (Chi 2 = 5.84; I 2 = 49%; P = 0.12), the pooled analysis was performed using a fixed-effect model. Two studies were not included in the meta-analysis because IDWG was not expressed as mean (SD) difference between pre-and post-treatment values [21,44]. In the study by Bellomo et al, IDWG changed from baseline to 6 months; in controls it ranged from 1.31 ± 0.33 to 1.32 ± 0.32 kg (P = 0.57) and in the treatment group it decreased from 1.33 ± 0.33 to 1.2 ± 0.28 kg (P < 0.001) [41].…”

Section: Psychological/affective Interventionsmentioning

confidence: 99%

Interdialytic weight gain and educational/cognitive, counseling/behavioral and psychological/affective interventions in patients on chronic hemodialysis: a systematic review and meta-analysis

Bossola

Pepe

Antocicco³

et al. 2022

J Nephrol

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Background This work aimed to shed light on the notorious debate over the role of an educational/cognitive/behavioral or psychological approach in the reduction of interdialytic weight gain (IDWG) in patients on chronic hemodialysis. Methods Searches were run from 1975 to January 2022 on Medline, PubMed, Web of Science, and the Cochrane Library. The search terms included “hemodialysis/haemodialysis” AND “adherence” AND (“fluid intake” OR “water intake”) AND (“weight gain” OR “interdialytic weight gain” OR “IDWG”) AND “patient-level interventions. Randomized controlled studies were eligible if they were in English, published in a peer-reviewed journal and regarded adults patients with on chronic hemodialysis for at least 6 months; compared educational/cognitive and/or counseling/behavioral or psychological interventions to no intervention on interdialytic weight gain. Outcome of interest was interdialytic weight gain. The review was registered on the International Prospective Register of Systematic Reviews in Health and Social Care (PROSPERO, ID number CRD42022332401). Results Eighteen studies (1759 patients) were included in the analysis. Compared to the untreated group, educational/cognitive and/or counseling/behavioral interventions significantly reduced interdialytic weight gain with a pooled mean difference of − 0.15 kg (95% CI − 0.26, 30–0.05; P = 0.004). On the other hand, psychological/affective interventions reduced interdialytic weight gain with a pooled mean difference of − 0.26 kg (95% CI − 0.48, − 0.04; P = 0.020). Conclusions Educational/cognitive, counseling/behavioral or psychological/affective interventions significantly reduced the interdialytic weight gain in patients on chronic hemodialysis, although such reduction did not appear to be clinically relevant on hard outcomes. Graphical abstract

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“…The digital counseling protocol used in the ODYSSEE-KH program is organized within the framework of CBT and MI, which are evidence-based interventions that are commonly used to lower symptoms of anxiety and depression in patients with CKD while promoting HRQoL. [44][45][46] MI is a key component to evoking and reinforcing intrinsic motivation that is required to sustain long-term behavioral change for self-care management. 47 Notably, attrition rates were low in this pilot study, suggesting a need for resources of this kind and thus emphasizing the usability of this program.…”

Section: Discussionmentioning

confidence: 99%

Automated Digital Counseling Program (ODYSSEE-Kidney Health): A Pilot Study on Health-Related Quality of Life

et al. 2023

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Background: In-person counselling programs promote self-care behaviour and health-related quality of life (HRQoL). ODYSSEE Kidney Health (ODYSSEE-KH) is an automated, scalable, digital counselling program for patients with CKD. This open-label, single-arm pilot study tested the efficacy potential of ODYSSEE-KH to improve HRQoL in patients with CKD. Methods: Adults with categories G3b to 5D CKD were recruited from nephrology clinics in Toronto, Canada. Patients (n=29) received access to ODYSSEE-KH in conjunction with usual care. Generalized linear models and pairwise comparisons of mean change scores were conducted to assess the primary outcome: Mental Component Score (MCS) of the Kidney Disease Quality of Life – Short Form (KDQoL-SF) instrument. Secondary outcomes included: MCS mental health scale, 36-item KDQoL-SF, Generalized Anxiety Disorder scale (GAD-7), Patient Health Questionnaire for depression (PHQ-9), Enhancing Recovery in Coronary Heart Disease Social Support Instrument (ESSI), and 3-item Revised UCLA Loneliness (RULS-3) scale. Results: Mean age was 53.5 years (SD=18.3); 35% women; 56% White; 93% completed ≥ post-secondary education; patients came from the Multi-Care Kidney Clinic (n=9), the Home Peritoneal Dialysis Unit (n=12), and the Home Hemodialysis Unit (n=8); and 24 participants completed the 4-month end of study questionnaires. Outcomes were assessed according to tertiles of program logon minutes: median (range) = 67 (62-108), 212 (119-355), and 500 (359-1573) minutes. Patients in the highest tertile of engagement showed significant improvements on the MCS vs. the moderate tertile group (p = 0.01). Significant dose-response associations were observed for MCS Mental Health (p<0.05), KDQoL Burden on Kidney Disease (p<0.01), KDQoL Effect of Kidney Disease on Everyday Life (p<0.01), aggregated KDQoL summary (p<0.05), GAD-7 (p<0.01), PHQ-9 (p<0.05), ENRICHD-SSI (p<0.01), and RULS-3 (p<0.01). Conclusion: ODYSSEE-KH demonstrated feasibility as an automated, scalable, digital self-care program for patients with CKD. There is evidence of efficacy potential to improve HRQoL. Further evaluation with a larger sample is warranted.

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Follow-Up Study on the Effect of Cognitive Behaviour Therapy on Haemodialysis Adherence

Cited by 8 publications

References 32 publications

Frailty and Age-Associated Assessments Associated with Chronic Kidney Disease and Transplantation Outcomes

Frailty and Age-Associated Assessments Associated with Chronic Kidney Disease and Transplantation Outcomes

Interdialytic weight gain and educational/cognitive, counseling/behavioral and psychological/affective interventions in patients on chronic hemodialysis: a systematic review and meta-analysis

Automated Digital Counseling Program (ODYSSEE-Kidney Health): A Pilot Study on Health-Related Quality of Life

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