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CompletedNCT03440853TASCCIUpdated Jul 11, 2022

Technology Assisted Stepped Collaborative Care Intervention

An interventional study of TASCCI and Technology Delivered Health Education Intervention in End-Stage Renal Disease and Hemodialysis, sponsored by University of Pittsburgh. Completed at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2022-07-11.

Sponsored by University of Pittsburgh · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
160
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This study evaluates a collaborative care intervention in reducing depression, fatigue and pain symptoms and improving health related quality of life in hemodialysis patients. Half of participants will receive the collaborative care intervention, while the other half will receive technology delivered health education information.

Read the detailed description

End-stage renal disease patients on hemodialysis experience substantial symptom burden with fatigue, pain and depression among the most debilitating and existing as symptom clusters. These symptom clusters can exacerbate one another, and are independent and strong predictors of poor health-related quality of life in hemodialysis patients. This study will look at the effect of a 12 week stepped care intervention on changes in depression, pain or fatigue and health related quality of life.

02

Conditions studied

  • End-Stage Renal Disease
  • Hemodialysis
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. 18 years or older
  2. undergoing thrice-weekly maintenance hemodialysis for > 3 months
  3. English speaking
  4. able to provide informed consent
  5. no evidence of thought disorder, delusions or active suicidal ideation

Exclusion criteria

Exclusion Criteria:

  1. thought disorder, delusions or active suicidal ideation
  2. active substance abuse
  3. too ill or cognitively impaired to participate based on clinicians' judgment
  4. anticipated life expectancy of less than 1 year
  5. unable or unwilling to adhere to study protocol
  6. participating in another clinical trial or taking an investigational drug
  7. scheduled for living donor kidney transplant within next 6 months
  8. relocating to another dialysis unit within 6 months
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
160 participants (actual)

Study arms

  • Experimental
    TASCCI

    Patients randomized to TASCCI will receive a stepped-care approach of pharmaco and/or behavioral therapy for 12 weeks. The intervention will target 1 or more symptoms based on patients' report of clinical levels of each symptom and patient preference.

    Behavioral: TASCCI

  • Other
    Technology Delivered Health Education

    Patients randomized to the Technology Delivered Health Education Intervention health education group will receive technology delivered health education material on topics relevant to dialysis.

    Other: Technology Delivered Health Education Intervention

Interventions

  • BehavioralTASCCI

    TASCCI is a stepped-care collaborative care approach of pharmaco- and/or behavioral-therapy for a 12 week period. The intervention will target 1 or more symptoms based on patients' report of clinical levels of each symptom and patient preference. A trained behavioral therapist will deliver weekly video conferencing sessions during dialysis treatment.

  • OtherTechnology Delivered Health Education Intervention

    The Technology Delivered Health Education Intervention will deliver weekly video conferencing sessions to deliver online educational material from the National Kidney Foundation. These sessions will be delivered by a care coordinator.

05

What researchers measure

Primary outcomes

  1. Change in depression from baseline to 12 weeks

    Depressive symptoms will be measured using the Beck Depression Inventory-II

    Time frame: Baseline and Post 12 week intervention

  2. Change in pain from baseline to 12 weeks

    Pain symptoms will be measured using the Brief Pain Inventory

    Time frame: Baseline and Post 12 week intervention

  3. Change in fatigue from baseline to 12 weeks

    Fatigue symptoms will be measured using the FACIT-F

    Time frame: Baseline and Post 12 week intervention

Secondary outcomes

  1. Change in adherence to medications

    Adherence will be measured using the Medication Adherence Questionnaire (MAQ) Morisky Green Levine

    Time frame: Baseline, 3 month, 6 month, 12 month

  2. Change in adherence to fluid restriction

    Fluid restriction adherence will be determined by inter-dialytic weight gain percentage (of post dialysis weight over preceding 1 month) obtained by reviewing dialysis records. Those with IDWG% \>3.5% will be classified as non-adherent

    Time frame: Baseline, 3 month, 6 month, 12 month

  3. Change in adherence to hemodialysis treatments

    Non-adherence with dialysis will be defined by the percentage of all dialysis sessions skipped and/or requested by the patient to be shortened by ≥ 10 minutes over the 12 week intervention period.

    Time frame: Baseline and Post 12 week intervention

Other outcomes

  1. To explore effect of TASCCI (hs-CRP, IL-6, IL-10 and TNF-α) on biomarkers of inflammation

    Effect of intervention on biomarkers of inflammation be measured by improvements in inflammatory cytokines.

    Time frame: Baseline and Post 12 week intervention, 6 month

06

Study locations

1 site
  • University of Pittsburgh
    Pittsburgh, Pennsylvania 15213, United States
07

Registry details

Key details

Study ID
NCT03440853
Lead sponsor
University of Pittsburgh
Collaborators
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), University of New Mexico
Responsible party
Manisha Jhamb (Associate Professor of Medicine, University of Pittsburgh) — Principal investigator
First posted
Feb 22, 2018
Start date
Mar 28, 2018
Primary completion
Apr 29, 2022
Completion
Jun 30, 2022
Last update
Jul 11, 2022

Study contacts

Manisha Jhamb, MD
principal investigator · University of Pittsburgh

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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