Abstract: TH-PO799

Internet-Based Positive Psychological Intervention for Hemodialysis Patients with Comorbid Depression: Design and Feasibility

Session Information

Category: Dialysis

  • 607 Dialysis: Epidemiology, Outcomes, Clinical Trials - Non-Cardiovascular

Authors

  • Burrows, Brett, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States
  • Wilund, Ken, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States
  • Cohn, Michael A, University of California San Francisco, San Francisco, California, United States
  • Moskowitz, Judith T, Northwestern University, Chicago, Illinois, United States
  • Xu, Shuo, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States
  • Hernandez, Rosalba, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States
Background

Depression is the most pervasive psychological issue facing hemodialysis (HD) patients and treatment strategies have mainly concentrated on the use of pharmacotherapy. Alternative treatment strategies that circumvent drug-related side effects and poor medication adherence (i.e., psychosocial interventions) have not been the focus for therapy and few published studies exist. The aim of the current trial was to determine the feasibility and acceptability of a 5-week Internet-based positive psychological intervention in HD patients with comorbid depression.

Methods

HD patients (n=14) with elevated symptoms of depression were enrolled in a single-arm pre-post pilot trial with clinical assessments at baseline and immediately post intervention. Chairside during regularly scheduled HD treatment, patients completed on-line modules promoting skills for increasing positive emotion over a 5-week period using an Apple IPad. Targeted skills included noting of daily positive events, cultivation of gratitude, practicing positive reappraisal, partaking in acts of kindness, and engagement in mindfulness/meditation.

Results

Mean age was 57.4 years; 50% female; 50% non-Hispanic White; mean duration on dialysis was 3.6 years. Twelve of 14 patients completed the program for an 85.7% retention rate. Participants felt satisfied overall with each session and offered consistently positive feedback. At the end of the intervention, significant improvements were evident for depressive symptoms (15.3 vs. 10.9; p=0.04) as measured by the Center for Epidemiological Studies Depression Scale. Statistical trends indicated clinically meaningful improvement in emotional well-being, kidney disease burden, and quality of social interactions as per the Kidney Disease Quality of Life Instrument.

Conclusion

Results indicate that an innovative and low-cost Internet-based positive psychological intervention represents a feasible and useful therapeutic option for HD patients with comorbid depression. This psychosocial strategy can be a valuable self-guided tool that reduces costly face-time with clinical staff.