Collaborative Care Cuts Fatigue, Pain in ESKD Hemodialysis Patients

FRIDAY, June 23, 2023 (HealthDay News) -- A technology-assisted stepped collaborative care intervention can reduce fatigue and pain among patients with end-stage kidney disease (ESKD) undergoing hemodialysis, according to a study published online June 20 in JAMA Internal Medicine.

Manisha Jhamb, M.D., M.P.H., from the University of Pittsburgh School of Medicine, and colleagues compared the effectiveness of a stepped collaborative care intervention versus health education control for reducing fatigue, pain, and depression among ESKD patients undergoing long-term hemodialysis. The intervention group received 12 weekly sessions of cognitive behavioral therapy (CBT) delivered via telehealth and/or pharmacotherapy using a stepped approach in collaboration with dialysis and primary care teams, while the attention control group received six health education telehealth sessions (83 and 77 patients, respectively).

The researchers found that patients in the intervention group experienced statistically and clinically significant reductions in fatigue and pain severity at three months compared with controls in the intention-to-treat analyses (mean difference, 2.81 and −0.96, respectively). At six months, these effects were sustained (mean difference, 3.73 and −1.49, respectively). At three months, there was a statistically significant but small improvement seen in depression (mean difference, −1.73). Both groups had similar adverse events.

"Our results showed that among patients undergoing hemodialysis, a 12-week CBT-based stepped collaborative care intervention can offer clinically significant improvements in fatigue and pain," the authors write.

Several authors disclosed ties to the biopharmaceutical industry.

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