Motivational Interviewing for Chronic Kidney Failure Adherence

Recruiting at 5 trial locations

Overseen By Marylou Wallace, MPH

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Vanderbilt University Medical Center

Disqualifiers: Non-African American, Severe illness, Non-English, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 24 weeks

176 Participants Needed

Trial Summary

What is the purpose of this trial?

MoVE Trial is a randomized clinical trial designed to rigorously test the impact of a behavioral intervention (culturally tailored motivational interviewing - (MOVE)) delivered by trained health coaches, on hemodialysis treatment non-adherence. It is a a two-arm, parallel group randomized clinical trial with 24-week follow-up. It involves completion of surveys by patients enrolled in the study. It also involves participation in motivational interviewing sessions by patients who are randomized to the intervention (MI).

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It focuses on motivational interviewing to improve adherence to hemodialysis treatment.

What data supports the effectiveness of the treatment Motivational Interviewing for Chronic Kidney Failure Adherence?

Research shows that motivational interviewing can improve adherence to medical treatments and enhance emotional well-being in patients with chronic kidney disease. Studies have found that patients receiving motivational interviewing reported better adherence, lower depression and anxiety, and improved quality of life. ^{1 2 3 4 5}

Is motivational interviewing safe for humans?

Motivational interviewing has been used safely in various studies to help people manage chronic conditions like high blood pressure and kidney disease. There are no reports of harmful effects from using this approach in these studies. ^{1 3 4 5 6}

How is motivational interviewing different from other treatments for chronic kidney failure?

Motivational interviewing is unique because it focuses on enhancing a patient's own motivation to change, rather than relying on persuasion from healthcare providers. This patient-centered approach helps individuals with chronic kidney disease better adhere to their treatment plans by addressing their personal ambivalence and encouraging self-motivation. ^{1 3 4 5 7}

Research Team

Ebele M Umeukeje, MD, MPH

Principal Investigator

Vanderbilt University Medical Center

Eligibility Criteria

The MoVE Trial is for African American adults who are on hemodialysis for kidney failure and have missed or shortened at least one dialysis session. It's not for those planning a transplant, switching to peritoneal dialysis soon, with severe illness or mental impairment, non-English speakers, without documented non-adherence issues, hospitalized or excused absences from treatment.

Inclusion Criteria

I am currently undergoing hemodialysis.

I have missed or shortened a dialysis session in the last 2 months.

I have been on hemodialysis for over a month.

Exclusion Criteria

I am scheduled for a transplant within the next 6 months.

I am planning to switch to peritoneal dialysis soon.

You have not missed any dialysis treatments without a good reason.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive motivational interviewing intervention and complete surveys

24 weeks

Regular sessions with health coaches

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

Treatment Details

Interventions

• Motivational interviewing

Trial Overview This trial tests if motivational interviewing by health coaches can help patients stick to their hemodialysis schedule. Participants will be randomly placed into two groups: one receiving the intervention and the other not. They'll complete surveys and attend sessions over 24 weeks.

Participant Groups

Group I: Participants receiving intervention Experimental Treatment 1 Intervention

Motivational interviewing intervention

Group II: Standard of Care Active Control 1 Intervention

Standard of Care

Who Is Running the Clinical Trial?

Vanderbilt University Medical Center

Lead Sponsor

Trials

922

Recruited

939,000+

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Collaborator

Trials

2,513

Recruited

4,366,000+

Findings from Research

Motivational interviewing (MI) is a promising strategy to enhance patient motivation and adherence to treatment in individuals with chronic kidney disease (CKD), which can be challenging due to the complexity of their medical management.

While MI shows potential in improving self-management among CKD patients, further research is needed to establish its efficacy and mechanisms, as well as to develop effective training methods for healthcare practitioners.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Motivational interviewing to engage patients in chronic kidney disease management. Martino, S.[2021]

A 6-month individual intervention program using motivational interviewing significantly improved treatment adherence, reduced depression and anxiety levels, and enhanced health-related quality of life in 42 patients with advanced chronic kidney disease.

Patients also showed better control of biochemical parameters after the intervention, indicating that psychological support can positively impact both emotional and physical health in ACKD management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Motivational interviewing promotes adherence and improves wellbeing in pre-dialysis patients with advanced chronic kidney disease. García-Llana, H., Remor, E., del Peso, G., et al.[2022]

A randomized controlled trial is currently underway to evaluate the effectiveness of motivational interviewing in improving medication adherence among 190 African American patients with uncontrolled hypertension, compared to usual care.

The study aims to assess not only medication adherence but also changes in blood pressure, self-efficacy, and intrinsic motivation over a 12-month period, highlighting the potential of motivational interviewing as a patient-centered approach in managing hypertension.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An RCT of the effect of motivational interviewing on medication adherence in hypertensive African Americans: rationale and design. Ogedegbe, G., Schoenthaler, A., Richardson, T., et al.[2022]

In a study involving 60 chronic hemodialysis patients, those who received four motivational interviewing sessions showed a significant increase in treatment adherence compared to the control group.

While there was no overall difference in quality of life scores between the two groups, the experimental group experienced a significant improvement in their quality of life from the posttest to the 3-month follow-up.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Effect of Motivational Interviewing on Adherence to Treatment and Quality of Life in Chronic Hemodialysis Patients: A Randomized Controlled Trial. Ok, E., Kutlu, Y.[2021]

A pilot study involving 29 adult patients undergoing outpatient hemodialysis indicated that staff-delivered motivational interviewing can positively influence treatment adherence, including dialysis attendance and biochemical markers like phosphorous and albumin levels.

While the intervention did not significantly change patient autonomy support scores, it was generally accepted by both patients and staff, suggesting it could be a valuable approach to enhance adherence in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Motivational Interviewing in Dialysis Adherence Study (MIDAS). Russell, CL., Cronk, NJ., Herron, M., et al.[2022]

A study involving 26 culturally and linguistically diverse participants with diabetes, chronic kidney disease, and cardiovascular disease revealed that a lack of knowledge about medications significantly hinders their self-efficacy in managing these conditions.

Motivational interviewing, conducted through interpreter services, highlighted the need for culturally sensitive interventions to improve medication understanding and self-management skills among diverse populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Motivational interviewing to explore culturally and linguistically diverse people's comorbidity medication self-efficacy. Williams, A., Manias, E., Cross, W., et al.[2018]

Motivational interviewing (MI) is a therapeutic tool designed to enhance patient motivation for lifestyle changes in individuals with chronic kidney disease, emphasizing that motivation should come from the patient rather than the healthcare provider.

This approach helps patients articulate their own reasons for change, which can reduce resistance to adopting healthier habits and improve compliance with medical recommendations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[The use of motivational interviewing (MI) in patients with chronic renal failure]. Zawadzka, B., Kleja, J.[2015]

References

1. Switzerland pubmed.ncbi.nlm.nih.gov

Motivational interviewing to engage patients in chronic kidney disease management. [2021]

2. United States pubmed.ncbi.nlm.nih.gov

Motivational interviewing promotes adherence and improves wellbeing in pre-dialysis patients with advanced chronic kidney disease. [2022]

3. United States pubmed.ncbi.nlm.nih.gov

An RCT of the effect of motivational interviewing on medication adherence in hypertensive African Americans: rationale and design. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

The Effect of Motivational Interviewing on Adherence to Treatment and Quality of Life in Chronic Hemodialysis Patients: A Randomized Controlled Trial. [2021]

5. United States pubmed.ncbi.nlm.nih.gov

Motivational Interviewing in Dialysis Adherence Study (MIDAS). [2022]

6. England pubmed.ncbi.nlm.nih.gov

Motivational interviewing to explore culturally and linguistically diverse people's comorbidity medication self-efficacy. [2018]

7. Poland pubmed.ncbi.nlm.nih.gov

[The use of motivational interviewing (MI) in patients with chronic renal failure]. [2015]