A Feasibility Cluster Randomised Control Trial of a Person-Centred Fluid Adherence Intervention for Adults Receiving...

Adherence to fluid restriction is an essential component of haemodialysis (HD) self-management, although educational interventions are rarely adjusted to meet a person's health literacy abilities. This study aimed to evaluate the feasibility of a person-centred intervention to improve fluid adherence in adults receiving HD.

A pragmatic, clustered, randomised control feasibility trial involved adults receiving HD for at least 3 months. The control group received standard care while the intervention group received standard care plus a 12-week self-management program that included 4 face-to-face individual teach-back sessions. Randomisation was based on HD treatment shifts. Primary outcomes were acceptability and feasibility (recruitment, retention, and completion rates) and secondary outcomes included patient-reported measures (knowledge, self-efficacy, health literacy, health-related quality of life [HRQoL]) and clinical outcomes (interdialytic weight gain [IDWG] and blood pressure [BP]).

The recruitment rate was 53.2% (50/94 screened) with participants (mean age 51 years, SD = 12.52) randomly allocated to intervention (n = 25) and control groups (n = 25). Overall, patient-reported outcome completion rates at baseline and 12 weeks were 88% and 90%, respectively. Retention rates for the intervention and control groups were 96% and 92%, respectively. There were no between group differences at baseline. At 12 weeks, significant improvements were found in the intervention group for knowledge, self-efficacy, health literacy, self-care index, and IDWG, but not HRQoL. The study found mixed results for BP.

This intervention was feasible and acceptable to deliver in the clinical setting during HD treatment and has the potential to improve health outcomes for adults on HD.