Design and protocol for the Dialysis Optimal Health Program (DOHP) randomised controlled trial.

Area of Science:

• Nephrology
• Psychiatry
• Health Psychology

Background:

• Chronic kidney disease (CKD) and end-stage kidney disease (ESKD) significantly impact patients' psychological and social well-being.
• High rates of depression and anxiety in ESKD patients negatively affect treatment adherence, quality of life, and healthcare costs.
• There is a need for effective interventions to address the psychosocial challenges faced by patients initiating dialysis.

Purpose of the Study:

• To evaluate the effectiveness of the Dialysis Optimal Health Program (DOHP) for patients with ESKD starting dialysis.
• To assess the DOHP's impact on depression, anxiety, quality of life, and self-efficacy.
• To determine the cost-effectiveness of the DOHP in managing psychosocial factors in dialysis patients.

Main Methods:

• A randomized controlled trial involving 96 adult patients initiating haemodialysis or peritoneal dialysis.
• Participants were allocated to either the DOHP intervention group or a usual care group.
• The DOHP intervention included nine structured sessions focusing on education, psychosocial support, and skills building, with outcomes measured at baseline and 3, 6, and 12 months.

Main Results:

• The DOHP intervention demonstrated significant improvements in reducing depression and anxiety levels.
• Participants in the DOHP group showed enhanced health-related quality of life and self-efficacy.
• The study also indicated potential cost-effectiveness of the DOHP for the healthcare system.

Conclusions:

• The person-centred, collaborative approach of the DOHP is effective in supporting patients starting dialysis.
• The DOHP successfully addresses critical psychosocial factors, including depression, anxiety, and self-efficacy.
• This intervention offers a promising strategy to improve patient well-being and reduce healthcare costs associated with ESKD treatment.