Pain management training may benefit patients on hemodialysis
Click Here to Manage Email Alerts
Key takeaways:
- Coping skills training included 12 weeks of remote sessions followed by 12 weeks of daily phone sessions.
- Patients trained on pain coping skills had a greater reduction in pain scores vs. those on usual care.
SAN DIEGO — Pain coping skills training may be beneficial for pain interference and related outcomes for patients on hemodialysis, according to data presented at ASN Kidney Week.
“Chronic pain is very common among patients being treated with maintenance hemodialysis, and for a variety of reasons, treatment is very challenging,” Laura M. Dember, MD, a professor at the University of Pennsylvania Perelman School of Medicine, said during a press briefing. The aim of the study was to define pain interference, which she said, “means the extent to which pain interferes with activity, mood and relationships.”
The HOPE Consortium Trial to Reduce Pain and Opioid Use in Hemodialysis was a multicenter study to explore chronic moderate or severe pain reported by patients on maintenance hemodialysis for end-stage kidney disease. Overall, 643 patients at 16 centers and 103 affiliated dialysis facilities were randomly assigned to receive a cognitive behavioral pain coping skills training intervention (n = 319) or usual care. The cohort was 44.8% female, 45.9% of participants were Black and 18.5% were Hispanic.
Participants went through an initial 12 weeks of remote sessions led by an instructor, followed by another 12 weeks of daily phone-based interactive voice response sessions.
Pain interference was assessed with the Brief Pain Inventory Interference subscale at 12, 24 and 36 weeks.
At 12 weeks, participants in the pain coping skills group had an almost 50% greater reduction in pain scores vs. those on usual care (HR = –0.49; 95% CI, –0.85 to –0.12).
The effects were sustained at week 24 (HR = –0.48; 95% CI, –0.86 to –0.11) but declined by week 36 (HR = –0.34; 95% CI, –0.72 to 0.04), Dember and colleagues noted.
Further, 50.9% of participants in the pain coping group had a decrease in Brief Pain Inventory Interference of at least one point vs. 36.6% in the usual care group at 12 weeks, and 55% of the intervention group showed improvement at week 24 vs. 42.8% of the usual care group.
Researchers also highlighted other benefits for those with pain coping skills training, including reduced pain intensity, improved quality of life and decreased levels of depression and anxiety. Reductions in pain catastrophizing were also seen at weeks 24 and 36.
“Our conclusions are that a pain coping skills training intervention adapted for hemodialysis decreased pain interference compared with usual care among hemodialysis patients with moderate or severe chronic pain,” Dember said. “[Future work includes developing] strategies for adopting pain coping skills in dialysis clinical care.”
Collapse
Dember LM, et al. SA-OR94. Presented at: ASN Kidney Week; Oct. 24-27, 2024; San Diego.
Click Here to Manage Email Alerts