Abstract: SA-PO303
Tailoring a Pain Coping Skills Training Intervention for Patients Receiving Maintenance Hemodialysis for Kidney Failure With Chronic Pain
Session Information
- Hemodialysis and Frequent Dialysis: Potpourri
November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Cukor, Daniel, Rogosin Institute, New York, New York, United States
- Brintz, Carrie E., Vanderbilt University Medical Center, Nashville, Tennessee, United States
- Heapy, Alicia, VA Connecticut Healthcare System - West Haven Campus, West Haven, Connecticut, United States
- Keefe, Francis J., Duke University School of Medicine, Durham, North Carolina, United States
- Steel, Jennifer L., University of Pittsburgh, Pittsburgh, Pennsylvania, United States
- Jhamb, Manisha, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
- Cheatle, Martin, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
- Mcneil, Daniel W., West Virginia University, Morgantown, West Virginia, United States
- Shallcross, Amanda J., New York University, New York, New York, United States
- Kimmel, Paul L., National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, United States
- Dember, Laura M., University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
Group or Team Name
- HOPE Consortium
Background
Patients with kidney failure undergoing maintenance hemodialysis (HD) have a substantial burden of pain symptoms that are consistently identified as underdiagnosed and undertreated. Pain Coping Skills Training (PCST) is a first-line behavioral treatment for pain, but there are unique challenges in applying these skills to patients treated with in-center HD. We describe PCST adaptations that address these challenges as part of an ongoing multi-center clinical trial (HOPE study) designed to evaluate the effectiveness of telehealth PCST compared to usual care for reducing pain interference among patients treated with HD.
Methods
Prior to initiating the trial, a team of psychologists specializing in psychosocial treatments for kidney disease or chronic pain adapted the intervention protocol from standard PCST with input from patient representatives. PCST adaptations were based on unique considerations for HD patients (e.g., treatment demands, unique pain complaints, psychiatric comorbidity, and diverse socioeconomic and health literacy levels). PCST was adapted for remote delivery with flexible options so patients could complete sessions using video or audio, with their own or a provided device, and at dialysis or another location. Content adaptations included pain coping skills applied to disease/treatment-related pain, addressing pain-related depression, sleep difficulty and anxiety, and incorporating motivational interviewing to facilitate desired opioid reduction or other individual value-based goals. Patient-facing materials used patient-centered language with input from patient representatives. Participants were recruited from dialysis facilities across the United States and those randomized to PCST received 12 weekly, 45-minute sessions via telemedicine.
Results
Among the 139 participants who had, as of May18, 2022, reached Week 12 of PCST study participation a total of over 1330 PCST sessions have been completed, and the mean number of sessions conducted was 11 with 93.5% (n=130) completing the minimum target of >8 sessions.
Conclusion
The high level of engagement to date supports the acceptability of a tailored, scalable nonpharmacologic treatment for reducing pain burden in patients on HD.
Funding
- NIDDK Support