(HealthDay News) — A technology-assisted stepped collaborative care intervention can reduce fatigue and pain among patients with end-stage kidney disease (ESKD) undergoing hemodialysis, according to a study published online in JAMA Internal Medicine.

Manisha Jhamb, MD, MPH, from the University of Pittsburgh School of Medicine, and colleagues compared the effectiveness of a stepped collaborative care intervention versus health education control for reducing fatigue, pain, and depression among ESKD patients undergoing long-term hemodialysis. The intervention group received 12 weekly sessions of cognitive behavioral therapy (CBT) delivered via telehealth and/or pharmacotherapy using a stepped approach in collaboration with dialysis and primary care teams, while the attention control group received 6 health education telehealth sessions (83 and 77 patients, respectively).

The researchers found that patients in the intervention group experienced statistically and clinically significant reductions in fatigue and pain severity at 3 months compared with controls in the intention-to-treat analyses (mean difference, 2.81 and −0.96, respectively). At 6 months, these effects were sustained (mean difference, 3.73 and −1.49, respectively). At 3 months, there was a statistically significant but small improvement seen in depression (mean difference, −1.73). Both groups had similar adverse events.

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“Our results showed that among patients undergoing hemodialysis, a 12-week CBT-based stepped collaborative care intervention can offer clinically significant improvements in fatigue and pain,” the authors write.

Several authors disclosed ties to the biopharmaceutical industry.

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