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Abstract: PO1077

A Pilot Randomized Control Trial of an Energy Management Program for Adults on Chronic Hemodialysis with Fatigue: The Fatigue-HD Study

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Farragher, Janine F., University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
  • Ravani, Pietro, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
  • Manns, Braden J., University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
  • Elliott, Meghan J., University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
  • Thomas, Chandra Mary, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
  • Donald, Maoliosa, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
  • Hemmelgarn, Brenda, University of Alberta Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada
Background

How to reduce fatigue and its impact on life participation is a top-ten unanswered research question among patients treated with chronic hemodialysis. We aimed to determine the feasibility of conducting a randomized controlled trial, to investigate an energy management education program for the chronic hemodialysis population.

Methods

We conducted a parallel-arm, 1:1, blinded pilot RCT at six hemodialysis units in Calgary, Canada. Patients who had moderate or severe fatigue on the Fatigue Severity Scale, and met other study eligibility criteria, were invited to participate. Consenting participants were randomized to general self-management education or the Personal Energy Planning (PEP) program, a tailored 7-9 week energy management program that guides participants in practicing efficient energy expenditure during valued life activities. We assessed study eligibility, recruitment and attrition rates. We then computed standardized intervention effects (Cohen’s D statistic) on self-reported fatigue and life participation measures, compared to control, at immediate post-intervention and 12 weeks post-intervention.

Results

Of 253 people on hemodialysis screened, 153 were eligible to be approached (clinically stable and English-speaking). 42 (26%) were interested and consented to participate, and 30 met all study eligibility criteria were enrolled (mean age 62.4, 60% male). 22 (73%) enrolled participants completed all study procedures. Medium intervention effects were observed compared to control on the global life participation scale, global life participation satisfaction scale, and COPM-Performance Scale at immediate post-intervention follow-up. At 12-week post-intervention, large and very large intervention effects were observed on the COPM Performance and Satisfaction Scales, respectively, compared to control. Minimal to no intervention effects were seen on other life participation or fatigue measures.

Conclusion

We have shown it is feasible to enroll and follow patients on hemodialysis with fatigue in a randomized controlled trial of an energy management intervention. Since the intervention led to improved life participation on some scales, we have justified the need for, and feasibility of, a larger trial.

Funding

  • Government Support - Non-U.S.