Abstract: TH-PO254
Psychosocial Interventions for Preventing and Treating Depression in Dialysis Patients: A Cochrane Review and Meta-Analysis
Session Information
- Hemodialysis and Frequent Dialysis - II
November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Natale, Patrizia, Diaverum, Lund, Sweden
- Palmer, Suetonia, University of Otago, Christchurch, New Zealand
- Ruospo, Marinella, Diaverum, Lund, Sweden
- Hegbrant, Jorgen BA, Diaverum, Lund, Sweden
- Strippoli, Giovanni F.M., Diaverum, Lund, Sweden
Background
People with end-stage kidney disease treated with dialysis are frequently affected by major depression. Psychological and social support are potential treatments for depression, although a Cochrane review in 2005 identified zero eligible studies. This is an update of the Cochrane review published in 2005 to evaluate the available evidence for using psychosocial interventions to prevent and treat depression in patients treated with dialysis for end-stage kidney disease (ESKD).
Methods
The specialized register of Cochrane Kidney and Transplant was searched for randomized trials (RCTs) reporting psychosocial interventions for prevention and treatment of depression among adults treated with long-term dialysis. Two authors independently screened citations for eligibility, extracted data, and assessed risk of bias using the Cochrane tool. Evidence certainty was evaluated using GRADE.
Results
Thirty-one studies (1820 participants) were eligible. Twenty-four new studies were added to this 2018 update. Seven studies originally excluded from the 2005 review were included as they met updated review eligibility criteria. Trial duration ranged between three weeks and one year. Median study age was 50.8 years. Methodological reporting was incomplete for most studies. Cognitive-behavioural therapy probably improves depression symptoms (mean difference [MD] -6.10, 95% confidence interval [CI] -8.63 to -3.57; moderate certainty) and health-related quality of life (standardized MD [SMD] 0.51, 95% CI 0.19 to 0.83; moderate certainty). Exercise probably improves depression symptoms (MD -7.61, 95% CI -9.59 to -5.63; moderate certainty) and health-related quality of life (MD 3.06, 95% CI 2.29 to 3.83; moderate certainty). Counselling and relaxation techniques probably reduce depressive symptoms (MD - 3.84, 95% CI -6.14 to -1.54; moderate certainty and MD -5.77, 95% CI -8.76 to -2.78; moderate certainty, respectively). In very low certainty evidence, the effects of acupressure, telephone support, and meditation were uncertain. Data on adverse events were sparse.
Conclusion
Cognitive-behavioural therapy, exercise, counselling, or relaxation techniques probably reduce depressive symptoms for adults with ESKD treated with dialysis. Evidence for other psychosocial interventions is uncertain.