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Abstract: PO1080

Feasibility and Acceptability of Symptom Monitoring with Feedback Trial (SWIFT) for Adults on Hemodialysis: A Pilot ANZDATA Registry-Based Cluster Randomized Trial

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Morton, Rachael L., NHMRC Clinical Trials Centre, Camperdown, New South Wales, Australia
  • Dansie, Kathryn, Australia and New Zealand Dialysis and Transplant Registry, Adelaide, South Australia, Australia
  • Bennett, Paul N., Satellite Healthcare, San Jose, California, United States
  • Duncanson, Emily, Australia and New Zealand Dialysis and Transplant Registry, Adelaide, South Australia, Australia
  • Viecelli, Andrea K., Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
  • Jesudason, Shilpa, Royal Adelaide Hospital, Adelaide, South Australia, Australia
  • Shah, Karan Ketan, NHMRC Clinical Trials Centre, Camperdown, New South Wales, Australia
  • Brown, Chris, NHMRC Clinical Trials Centre, Camperdown, New South Wales, Australia
  • Palmer, Suetonia, University of Otago Christchurch, Christchurch, New Zealand
  • Caskey, Fergus J., University of Bristol, Bristol, Bristol, United Kingdom
  • McDonald, Stephen P., Australia and New Zealand Dialysis and Transplant Registry, Adelaide, South Australia, Australia

Group or Team Name

  • SWIFT
Background

We designed a registry-based randomized trial to test whether the collection and feedback of symptoms improves health-related quality of life (HR-QoL). The pilot study's aim was to determine technical feasibility and patient-clinician acceptability of electronic tablet-based data capture and feedback integrated within the ANZDATA registry.

Methods

Hemodialysis units were cluster randomized to 3-monthly symptom monitoring using the Integrated Palliative Outcome Scale-Renal (IPOS-Renal) with feedback to clinicians plus 6-monthly HR-QoL using EQ-5D-5L questionnaire (intervention group); vs HR-QoL alone (control group). Feasibility and acceptability outcomes included, 1) individualized survey generation using QR codes linked to ANZDATA records; 2) patient completion rate and time; 3) delivery of individualized symptom reports.

Results

Technical feasibility was demonstrated by successful development of a Qualtrics survey platform presented on tablet computers, use of QR reader codes to verify correct patients from ANZDATA, with a link to the relevant survey for the patient’s allocation and study timepoint. 226 patients (intervention =109; control =117), from 4 Australian units with median dialysis vintage of 1.6 years, mean age 62 years, 31% females, completed at least one symptom or HR-QoL measure, (72% of eligible patients, range 44-90%). Mean completion time was 6.5 minutes for IPOS-Renal (66% nurse assisted), 3.5 minutes for EQ-5D-5L. Consolidated symptom feedback reports and evidence-based symptom management guidelines for Nephrologists and dialysis nurse managers were delivered electronically within 2 weeks of measurement.

Conclusion

Electronic symptom monitoring in adults on hemodialysis with feedback to clinicians is feasible. These data support the commencement of the definitive trial in 3,072 patients.

SWIFT Pilot flow chart

Funding

  • Private Foundation Support