Finding the right fit: improving quality of life in dialysis patients using a personalized approach

Abstract

Patients with kidney failure undergoing dialysis often experience a reduced quality of life (QoL) due to various symptoms and high intensity of their treatment. Our research shows that patients who have a negative outlook on their disease, as expressed by feelings of helplessness or worrying, tend to have a lower QoL, while social support helped protect against this decline. For nearly all patients, fatigue stood out as patients' number one priority. Other symptoms and priorities varied greatly among patients, necessitating a personalized approach.

To address this, we developed a screening tool, patient-specific norm scores, and a personalized questionnaire to better assess individual patient functioning, and a therapist-guided personalized online treatment targeting patients' most important issues.

While there was no overall improvement in QoL, we found a large effect on the personalized outcome measure, with the intervention group showing significantly larger improvements on the QoL areas they prioritized for improvement as compared to the control group. Additionally, patients reported better coping skills. However, the online format and tasks were often considered too complex, with patients expressing a preference for personal contact, simpler tasks, and lower treatment intensity. These insights provide concrete suggestions to improve the suitability and effectiveness of future interventions.