Dr Neeru Agarwal1, DR BRENDAN SMYTH1,2, MS LAVERN GREENHAM3, MR CHRIS BROWN1, PROF ANDREA VIECELLI4,5, PROF RACHAEL MORTON1
1NHMRC Clinical Trials Centre, University Of Sydney, CAMPERDOWN, AUSTRALIA, 2DEPARTMENT OF RENAL MEDICINE, ST GEORGE HOSPITAL, KOGARAH, AUSTRALIA, 3AUSTRALIA AND NEW ZEALAND DIALYSIS AND TRANSPLANT REGISTRY, SOUTH AUSTRALIAN HEALTH AND MEDICAL RESEARCH INSTITUTE, ADELAIDE, AUSTRALIA, 4DEPARTMENT OF NEPHROLOGY, PRINCESS ALEXANDRA HOSPITAL, BRISBANE, AUSTRALIA, 5FACULTY OF MEDICINE, UNIVERSITY OF QUEENSLAND, BRISBANE, AUSTRALIA
Aim: This pilot study determined the feasibility of the collection of electronic tablet-based patient reported outcome measures (e-PROMs) with feedback of symptom scores to the treating team via the ANZDATA registry.
Background: Patients with kidney failure on haemodialysis experience considerable symptom burden associated with poor health-related quality of life (HRQoL). Symptoms are often underreported by patients or not discussed by their nephrologist resulting in undertreatment of potentially manageable symptoms.
Methods: The SWIFT pilot study was conducted in four Australian haemodialysis units, cluster randomised to either the intervention arm (3-monthly symptom monitoring [IPOS-Renal] with feedback to the treating team and evidence-based guidance for symptom management) or control (usual care). The HRQoL outcome was measured at 6 months by the EQ-5D-5L visual analogue scale (VAS). Feasibility was assessed by participant response rate, retention rate and completion time. HRQoL and symptom burden scores were described.
Results: 226 participants completed the e-PROMs at least once (mean age 62yrs, 69% males, 78% White-European, median dialysis vintage 1.62yrs). Overall response rate was 72%. Retention rate was 60% for the intervention arm and 97% for the control. Median time to complete EQ-5D-5L plus IPOS-Renal at baseline for the intervention arm was 11.1 minutes (8.0, 14.3), and 4 minutes (IQR 3.0, 5.6) for the EQ-5D-5L only in the control arm. In the intervention arm both mean EQ-VAS (61 [SD 26] vs 71 [SD 19]) and overall IPOS-Renal symptom burden score (19.6 vs 15.9) improved after 6 months. The mean EQ-VAS score remained comparable for the control arm (74 [SD 21] vs 73 [SD 19]).
Conclusions: Electronic symptom monitoring among adults on haemodialysis with feedback to clinicians is feasible and may improve HRQoL.
Biography:
Dr Neeru Agarwal is a PhD Candidate at the NHMRC Clinical Trials Centre, University of Sydney. She is a Nephrologist with an interest in researching the use of routinely collected healthcare data to understand rare kidney conditions such as glomerular diseases. Neeru completed her advanced training in Nephrology at Royal Prince Alfred Hospital and Concord Hospital and was a Clinical Fellow at the Imperial College of London, Hammersmith Hospital.