Collaborative Care Intervention for Chronic Kidney Disease

Study Overview
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Brief Summary
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The aims of the present study will be to pilot test the efficacy of a collaborative care intervention in patients awaiting kidney transplant to reduce symptoms of depression, pain, fatigue and improve quality of life.

Detailed Description
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Symptom management is critical to maintain quality of life in those with life limiting conditions. Stepped collaborative care interventions have been widely employed in the primary care setting for the treatment of depression and more recently have been utilized to treat other symptoms (e.g., pain) in a variety of settings. A recent meta-analyses concluded that collaborative care interventions were superior to usual care and are more cost-effective than face to face and pharmacological treatment for depression. Collaborative care interventions have begun to be extended to other settings but have not been tested in patients who are being treated with dialysis. The aims of the present study were to pilot test the efficacy of a collaborative care intervention in patients awaiting kidney transplant to reduce symptoms of depression, pain, fatigue and improve quality of life.

Official Title
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Collaborative Care Intervention for Kidney Transplant Patients

Conditions
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Kidney Transplant, Depression, Pain

Intervention / Treatment
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* Behavioral: Collaborative care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 18 or older Currently receiving dialysis at UPMC dialysis facility for chronic kidney disease Fluent in English Exclusion Criteria: Under the age of 18 years or over 90 years Not fluent in English

Ages Eligible for Study
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Minimum Age: 21 Years
Maximum Age: 95 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Intervention Model: Single Group Assignment
Interventional Model Description: Patient and caregiver will receive an IPAD with Vidyo software to complete the treatment sessions
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: collaborative care<br>To test the efficacy of a collaborative care intervention with patients treated with dialysis to reduce depression, pain, fatigue, and improve quality of life | Behavioral: Collaborative care<br>* Therapist will use iPad (Vidyo) once a week during dialysis for approximately one hour. The therapist will teach the patient cognitive-behavioral strategies to manage their mood and pain. The PI is a clinical psychologist and will provide supervision to the therapist providing the intervention. The sessions for depression will include (1) intake, (2) review of the rational for using CBT to treat depression and/or pain, (3) identifying thought patterns, (4) changing thought patterns, (5) relaxation techniques, (6) rest-activity pacing, and (7) coping strategies. Homework to practice these techniques will be provided after each session.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Depression Level | score on CES-D questionnaire | change from baseline at 3 month and 6 month | 
| Perceived Stress level | score on PSS questionnaire | change from baseline at 3 month and 6 month | 
| degree of Pain | score on the BPI questionnaire | change from baseline at 3 month and 6 month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Dyadic functioning | score on the Dyadic functioning questionnaire | change from baseline at 3 month and 6 month | 
| level of physical activity (mild, moderate or high) | calculated score on the International Physical Activity quationnaire | change from baseline at 3 month and 6 month | 
| sleep quality | score on the PSQI questionnaire | change from baseline at 3 month and 6 month | 
| quality of life | score on the KDQOL questionnaire | change from baseline at 3 month and 6 month | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Collaborative care intervention, kidney transplant