Abstract: FR-OR105
SWIFT: A Phase 3 Cluster-Randomized Registry Trial of Symptom Monitoring vs. Usual Care in Patients on Hemodialysis
Session Information
- High-Impact Clinical Trials
October 23, 2026 | Location: Bluebird Ballroom, Convention Center
Abstract Time: 11:45 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Morton, Rachael L., The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
- Brown, Chris, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
- Bennett, Paul N., Griffith University, Brisbane, Queensland, Australia
- Handke, William (Bill) A., Consumer Partner, Canberra, Australian Capital Territory, Australia
- Nasikkar, Prerana, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
- Muthuramalingam, Shyamsundar, Barossa Hills Fleurieu Local Health Network, Mount Barker, South Australia, Australia
- Alhuzaimi, Dana, Australia and New Zealand Dialysis and Transplant Registry, Adelaide, South Australia, Australia
- Smyth, Brendan, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
- Viecelli, Andrea K., Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
- Ducharlet, Kathryn, Eastern Health, Box Hill, Victoria, Australia
- Mount, Peter F., Austin Health, Heidelberg, Victoria, Australia
- Caskey, Fergus, University of Bristol, Bristol, England, United Kingdom
- Couchoud, Cécile, Registre REIN, Paris, France
- McDonald, Stephen P., Australia and New Zealand Dialysis and Transplant Registry, Adelaide, South Australia, Australia
Group or Team Name
- SWIFT Investigators
Background
Symptom monitoring has been shown to improve quality of life and overall survival in cancer patients. The multicentre, pragmatic Symptom monitoring WIth Feedback Trial (SWIFT) ACTRN12620001061921 aimed to test the impact of regular symptom assessment on quality of life in HD patients.
Methods
Australian HD units were randomly assigned to receive either 3-monthly symptom assessment using the Integrated Palliative Outcomes Scale (IPOS)-Renal, feedback of symptom scores to clinicians and patients with evidence-based guidance to manage symptoms, vs usual care. The primary outcome was Euro-Qol 5 dimension 5 level (EQ-5D-5L) utility between groups at 12-months, assessed using GEE models adjusted for unit size, public/private status, state, rural/metro location, and previous IPOS use. Secondary outcome measures included change in SONG-HD Fatigue score, change in IPOS score.
Results
92 units (56 clusters) with 2412 patients were randomized. At baseline, moderate to overwhelming weakness (in 50% of patients); difficulty sleeping (41%) and pain (38%) were most prevalent. Clinicians from intervention units viewed IPOS feedback scores 71% of the time at baseline, decreasing to 60% at 12-months. Patient-reported consultations about symptoms were 9% higher, p=0.005 in the intervention group at 12-months; perceived change in management was 7% higher, p=0.037. IPOS symptoms at each timepoint are shown in Fig1. Symptom monitoring had no effect on EQ-5D-5L utilities (Fig2) or SONG-HD Fatigue score over 12-months with adjusted mean difference between groups of 0.01, (95%CI -0.02, 0.04) and 0.04 (95%CI -0.23, 0.31). Sub-group analyses will be presented.
Conclusion
Compared with usual care, 3-monthly symptom assessment and feedback among HD patients was not associated with improvements in EQ-5D-5L utility or SONG-HD Fatigue score at 12-months.
Acknowledgment
The SWIFT investigators would like to thank all of the participating sites, patients, nurses and nephrologists as well as ANZDATA Registry staff, the Australian Teletrials Program, and consumer advisors for their support of this trial.
Fig1
Fig2
Funding
- Government Support - Non-U.S.