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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests whether motivational interviewing, a guided conversation technique that encourages positive behavior changes, can help individuals adhere better to their hemodialysis treatment plans. It targets African Americans who have been on hemodialysis for over a month and have recently missed or shortened treatments. Participants will either continue with their usual care or receive additional support through motivational interviewing sessions. The study aims to determine if this approach improves adherence to dialysis, which is crucial for managing chronic kidney failure. As an unphased trial, this study provides a unique opportunity to contribute to research that could enhance treatment adherence and improve health outcomes for others.

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 prior data suggests that this behavioral intervention is safe for patients with chronic kidney failure?

Research shows that motivational interviewing, a type of counseling, is generally safe for people with chronic kidney disease. In past studies, patients found it helpful for managing their treatment and making lifestyle changes. This therapy aids patients in following their treatment plans, such as attending dialysis sessions.

There are no known physical side effects, as it primarily involves talking and listening. It focuses on conversations that support positive changes, not on medication or medical procedures. Therefore, safety concerns are minimal, and patients typically handle it well. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Unlike traditional treatments for chronic kidney failure that primarily focus on medical interventions like dialysis or medication, motivational interviewing is a unique approach that centers on enhancing patient adherence through guided conversations. This technique helps patients find personal motivation to stick with their treatment plans, potentially leading to better health outcomes. Researchers are excited about motivational interviewing because it empowers patients to take an active role in their care, which could complement existing medical treatments and improve their effectiveness.

What evidence suggests that motivational interviewing is effective for chronic kidney failure adherence?

Research has shown that motivational interviewing, which participants in this trial may receive, can help people with chronic kidney disease (CKD) adhere better to their treatment plans. Specifically, studies find that this approach helps patients maintain their hemodialysis schedule. Trained health coaches engage with patients to support positive behavioral changes. This method is particularly helpful for those who have missed or shortened dialysis sessions. Overall, motivational interviewing has proven effective in improving health outcomes by increasing patients' commitment to their treatment plans. ^{1 3 6 7 8}

Who Is on the Research Team?

Ebele M Umeukeje, MD, MPH

Principal Investigator

Vanderbilt University Medical Center

Are You a Good Fit for This Trial?

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 a very serious illness that cannot be cured.

Timeline for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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]

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]

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]

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]

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 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]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC3608718/

Motivational Interviewing for Patients with Chronic Kidney ... This article describes how motivational interviewing can be used with patients to enhance their motivation to address CKD and participate in treatment.

2. sigmapubs.onlinelibrary.wiley.com sigmapubs.onlinelibrary.wiley.com/doi/full/10.1111/wvn.12634

The effectiveness of patient activation interventions in adults ... This study aimed to examine the effectiveness of patient activation interventions on behavioral health-related outcomes among people with CKD stages 3–5.

3. reporter.nih.gov reporter.nih.gov/search/ZDfylt0TY0iSvKkfm_Oxxg/project-details/10504154

MOVE Trial Our long-term goal is to establish culturally sensitive strategies and multi-level interventions to improve outcomes in kidney disease. ... failureEvidence based ...

4. withpower.com withpower.com/trial/phase-kidney-failure-chronic-10-2023-93b02

Motivational Interviewing for Chronic Kidney Failure ... 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 ...

5. journals.lww.com journals.lww.com/jasn/fulltext/2024/10001/move_trial_protocol__motivational_strategies_to.1182.aspx

MoVE TRIAL Protocol: MotiVational Strategies to Empower... Findings will determine efficacy of culturally tailored MI on improving HD adherence in AA. ... Empiric Antibiotics and Infection Trends in CKD: Insights from the ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC3202953/

Motivational Interviewing to Engage Patients in Chronic ... Abstract. Patients with chronic kidney disease (CKD) must manage numerous medical treatments and lifestyle changes that strain their treatment adherence.

7. researchgate.net researchgate.net/publication/235619373_Motivational_Interviewing_for_Patients_with_Chronic_Kidney_Disease

Motivational Interviewing for Patients with Chronic Kidney ... This article describes how motivational interviewing can be used with patients to enhance their motivation to address CKD and participate in ...

8. bmcnephrol.biomedcentral.com bmcnephrol.biomedcentral.com/articles/10.1186/s12882-018-1075-2

improving outcomes in early chronic kidney disease with ... Meeting patients where they are: improving outcomes in early chronic kidney disease with tailored self-management support (the CKD-SMS study).