Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/140382
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Type: | Journal article |
Title: | Feasibility of Symptom monitoring WIth Feedback Trial (SWIFT) for adults on hemodialysis: a registry-based cluster randomized pilot trial |
Author: | Agarwal, N. Shah, K.K. Dansie, K. Bennett, P.N. Greenham, L. Brown, C. Smyth, B. McDonald, S. Jesudason, S. Viecelli, A.K. Morton, R.L. |
Citation: | BMC Nephrology, 2023; 24(1):1-12 |
Publisher: | Springer Science and Business Media LLC |
Issue Date: | 2023 |
ISSN: | 1471-2369 1471-2369 |
Statement of Responsibility: | Neeru Agarwal, Karan K. Shah, Kathryn Dansie, Paul N. Bennett, Lavern Greenham, Chris Brown, Brendan Smyth, Stephen McDonald, Shilpanjali Jesudason, Andrea K. Viecelli, Rachael L. Morton, and on behalf of the Symptom monitoring With Feedback Trial (SWIFT) Investigators |
Abstract: | Background: Patients with kidney failure on hemodialysis (HD) experience considerable symptom burden and poor health-related quality of life (HRQoL). There is limited use of patient reported outcome measures (PROMs) in facility HD units to direct immediate care, with response rates in other studies between 36 to 70%. The aim of this pilot study was to evaluate feasibility of electronic PROMs (e-PROMs) in HD participants, with feedback 3-monthly to the participants’ treating team, for severe or worsening symptoms as identifed by the Integrated Palliative Outcome Scale (IPOS-Renal), with linkage to the Australian and New Zealand Dialysis and Transplant (ANZDATA) registry, compared with usual care. Methods: This is a registry-based cluster-randomized controlled pilot trial involving all adults receiving HD in 4 satellite units in Australia over a 6-month period. HD units were cluster randomized 1:1 to the control (HRQoL data collection only) or intervention arm (symptom monitoring with feedback to treating team every 3 months). Feasibility was assessed by participant response rate (percentage of eligible HD participants, including new incident participants, who completed the questionnaire at each time point); retention rate (percentage of participants who completed the baseline questionnaire and all subsequent measures); and completion time. HRQoL and symptom burden scores are described. Results: There were 226 unique participants who completed the e-PROMs (mean age 62 years, 69% males, 78% White-European, median dialysis vintage 1.62 years). At 6 months, response rate and retention rate for the intervention arm were 54% and 68%, respectively, and 89% and 97% in the control arm. Median time to complete IPOS-Renal was 6.6 min (5.3, 10.1) at 3 months, and when combined with the outcome measure (EQ-5D-5L), the median time was 9.4 min (6.9, 13.6) at 6 months. Conclusions: Electronic symptom monitoring among HD participants with feedback to clinicians is feasible. Variations in response and retention rates could be potentially explained by the lengthier questionnaire, and higher frequency of data collection time points for participants in the intervention arm. A defnitive national RCT is underway. |
Keywords: | Hemodialysis; Patient Reported Outcome Measures; Quality of Life; Symptom Assessment; Registries; Cluster analysis; Randomized Controlled Trial; Medical Record Linkage |
Rights: | © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
DOI: | 10.1186/s12882-023-03399-5 |
Grant ID: | http://purl.org/au-research/grants/nhmrc/1092957 http://purl.org/au-research/grants/nhmrc/1194703 |
Published version: | http://dx.doi.org/10.1186/s12882-023-03399-5 |
Appears in Collections: | Medicine publications |
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hdl_140382.pdf | Published version | 2.5 MB | Adobe PDF | View/Open |
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