Improving adherence and biomedical markers in hemodialysis patients: The effects of relaxation therapy

Pasyar, Nilofar; Rambod, Masoume; Sharif, Farkhondeh; Rafii, Forough; Pourali-Mohammadi, Nasrin

doi:10.1016/j.ctim.2014.10.011

Cited by 27 publications

(19 citation statements)

References 32 publications

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“…The evaluated intervention was delivered by a variety of health care professionals in the different studies, with dietitians (10 trials) and nurses (9 trials) being the most frequent. Psychologists were the interventionists in seven trials, while a pharmacist [43] and relaxation therapy professional [39] delivered the intervention in one study each. The remaining eight studies had multiple staff involved or provided no specific information on the interventionist.…”

Section: Resultsmentioning

confidence: 99%

“…The dominant category was assigned by consensus, with guidance when necessary from the senior psychologist among the authors. Eleven studies evaluated educational or cognitive interventions, four had behavioural or counselling interventions [6, 12, 27, 45], four had psychological or affective interventions [33, 39, 48, 49] and fourteen studies had elements of different categories in the trialled intervention (refer to Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…The trialled intervention was effective in improving the adherence outcome measures in twelve studies, while in sixteen studies the intervention led to mixed results, with improvement in some pre-specified outcome measures but failing to show significant benefit in other adherence outcomes (refer to Table 1). For example, in twelve trials which reported two or more biochemical markers as surrogate outcome measures in response to adherence interventions, eight showed improvement in phosphate levels, but five of these studies [13, 24, 29, 39, 51] showed no significant improvement in other surrogate adherence outcomes such as calcium x phosphate product, PTH or potassium. The evaluated intervention, did not result in an improvement in any of the adherence outcome measures in eight trials, although two of these studies [37, 45] showed improvement in the participant’s knowledge and awareness about the relevant issues, as a result of the intervention (refer to Table 1).…”

Section: Resultsmentioning

confidence: 99%

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Strategies to improve dietary, fluid, dialysis or medication adherence in patients with end stage kidney disease on dialysis: A systematic review and meta-analysis of randomized intervention trials

et al. 2019

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BackgroundIn patients with end stage kidney disease (ESKD) on dialysis, treatment non-adherence is common and results in poor health outcomes. However, the clinical benefits of interventions to improve adherence in dialysis patients are difficult to evaluate since trialled interventions and reported outcomes are highly diverse/ heterogeneous. This review summarizes existing literature on randomized controlled trials (RCTs) evaluating adherence interventions in ESKD patients focusing on the intervention category, outcome efficacy and persistence of benefit beyond the intervention.MethodsWe performed electronic database searches in Medline, Embase & Cochrane CENTRAL upto 1st July 2018 for RCTs evaluating interventions to improve diet, fluid, medication or dialysis adherence in ESKD patients. Study characteristics including category of interventions, outcomes, efficacy and follow-up were assessed. Meta-analysis was used to compute pooled estimates of the effects on the commonest reported outcome measures.ResultsFrom 1311 citations, we included 36 RCTs (13 cluster-randomized trials), recruiting a total of 3510 dialysis patients (mean age 55.1 ± 5.8 years, males 58.1%). Overall risk of bias was ‘high’ for 24 and of ‘some concern’ for 12 studies. Most interventions (33 trials, 92%) addressed patient related factors, and included educational/cognitive (N = 11), behavioural / counselling (N = 4), psychological/affective (N = 4) interventions or a combination (N = 14) of the above. A majority of (28/36) RCTs showed improvement in some reported outcomes. Surrogate measures like changes in phosphate (N = 19) and inter-dialytic weight gain (N = 15) were the most common reported outcomes and both showed significant improvement in the meta-analysis. Sixteen trials reported follow-up (1–12 months) beyond intervention and the benefits waned or were absent in nine trials within 12 months post-intervention.ConclusionsInterventions to improve treatment adherence result in modest short-term benefits in surrogate outcome measures in dialysis patients, but significant improvements in trial design and outcome reporting are warranted to identify strategies that would achieve meaningful and sustainable clinical benefits.LimitationsPoor methodological quality of trials. Frequent use of surrogate outcomes measures. Low certainly of evidence.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Strategies to improve dietary, fluid, dialysis or medication adherence in patients with end stage kidney disease on dialysis: A systematic review and meta-analysis of randomized intervention trials

et al. 2019

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“…[19] In another study from Iran, Pasyar et al randomized hemodialysis patients for intervention of BRM and a control group. [20] There was significant improvement in the BRM group regarding blood urea nitrogen, phosphate and interdialytic weight gain.…”

Section: Discussionmentioning

confidence: 99%

The effect of Benson relaxation method on anxiety in the emergency care

Abdullah¹,

Koyuncu²,

Koyuncu

et al. 2019

Medicine

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Objective: To analyze clinical and sociodemographic properties of the patients as measured by the “Hospital Anxiety and Depression Scale-HADS” including the subscale regarding anxiety (HAD-A) in emergency department (ED) and to detect the effect of a session of Benson relaxation method (BRM) on high anxiety level. Methods: Adult patients presented to the state hospital ED in seven days were recruited in this prospective study. Patients with high (≥8) scores were randomized to the treatment or control groups. They were asked to pursue BRM to alleviate anxiety. Results: Six hundred thirty-four patients were recruited (mean age 44.1 and 52% were female). Patients with acute exacerbation or with psychiatric illness, with a systemic disease and higher acuity level had higher HAD-A scores ( P < .05). BRM group had a mean score change higher than controls (7.2 ± 2.9 vs 3.4 ± 2.6, t test, P = .026). Conclusions: Patients who underwent BRM had larger decreases in HAD-A scores than others.

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“…Chronic renal failure is considered a health issue in modern societies. 1 In the past few years, much attention has been paid to this issue in developed countries. 2 The final stage of chronic renal failure poses a clinical situation through which a kidney is not able to perform metabolic actions and keep balanced fluid and electrolytes in the body.…”

Section: Introductionmentioning

confidence: 99%

<p>The Effect of Peer Support on Hope Among Patients Under Hemodialysis</p>

Pasyar¹,

Rambod²,

Jowkar³

2020

IJNRD

Self Cite

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Introduction: Providing social support for patients under hemodialysis treatment can reduce their psychological, social, and physical problems. The present study aimed at determining the effect of peer support on hopefulness in patients under hemodialysis. Methods: This clinical trial with a pre/posttest design was conducted on 128 patients who had referred to the hemodialysis centers of Shiraz University of Medical Sciences in 2019. The patients were randomly divided into an intervention and a control group. The patients in the intervention group were supported by their peers for eight weeks and were provided with the usual care, but the controls were only provided with the usual care. The data were collected using Snyder Hope Scale. Then, the data were entered into the SPSS software, version 18 and were analyzed using independent t-test and paired t-test. Results: At baseline, the participants in both groups were similar with respect to the mean scores of hope and its subscales (p>0.05). However, there was a significant difference between the two groups in terms of hope and its subscales eight weeks after the intervention (p<0.001). Conclusion: The results confirmed the effect of peer support on increasing hope among the patients under hemodialysis. Peer support in informational, emotional, instrumental, and spiritual forms could create a positive incentive and increase hope among the patients. Clinical Trial Number: This clinical trial has been registered in the Iranian Registry of Clinical Trials (IRCT20190126042498N1).

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Improving adherence and biomedical markers in hemodialysis patients: The effects of relaxation therapy

Cited by 27 publications

References 32 publications

Strategies to improve dietary, fluid, dialysis or medication adherence in patients with end stage kidney disease on dialysis: A systematic review and meta-analysis of randomized intervention trials

Strategies to improve dietary, fluid, dialysis or medication adherence in patients with end stage kidney disease on dialysis: A systematic review and meta-analysis of randomized intervention trials

The effect of Benson relaxation method on anxiety in the emergency care

<p>The Effect of Peer Support on Hope Among Patients Under Hemodialysis</p>

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