University of Pittsburgh
The goal of this study is to learn if a collaborative care intervention of pharmaco-therapy and/or cognitive behavioral therapy (CBT), delivered in a real-world setting, improves symptoms of pain, fatigue and/or depression.
The goal of this study is to conduct a hybrid Type II effectiveness-implementation, cluster randomized trial of TĀCcare 2.0 facilitated by dialysis staff in a real-world setting. This is a multi-center, dialysis-clinic level cluster randomized trial of 424 patients from 36 dialysis clinics comparing TACcare 2.0 facilitated by dialysis staff versus usual care. Patients' dialysis clinic will be placed randomly into one of two study groups: the Technology Assisted Stepped Collaborative Care Intervention Group or the Usual Care Group. The intervention will target three of the most debilitating En…
Eligibility Criteria: 1. age 18 years or older; 2. undergoing thrice-weekly maintenance hemodialysis (HD) for \> 3 months; 3. English or Spanish speaking; 4. able to provide informed consent Ineligibility Criteria: 1. active thought disorder, delusions or active suicidal ideation 2. active substance abuse 3. enrolled in hospice or life expectancy \< 6 months (based on clinician's judgement) 4. too ill or cognitively impaired to participate based on renal provider's judgement 5. living kidney transplant scheduled in \<3 months 6. undergoing active cancer treatment. 7. enrolled in another res…
The TĀCcare 2.0 intervention will provide pharmacotherapy recommendations and/or CBT for pain, fatigue and depression. A stepped-treatment approach will be used to intensify treatment. CBT will be provided through 12 weekly telehealth sessions (done during dialysis treatment or from home) with the behavioral specialist. Booster sessions will be used to enhance the maintenance of effect following the initial intervention to complete a total 12 month intervention. A collaborative care approach will be used so that patients' symptom management will be integrated with their dialysis treatment. Throughout the study, participants will be asked to complete phone surveys about their symptoms and health.
Participants in the Usual Care Arm will continue with their usual care.
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