Symptom Monitoring With Supported Feedback in Advanced Chronic Kidney Disease
Recruiting now · Not applicable
Conditions studied: Chronic Kidney Disease (Stages 4 and 5), Health Related Quality of Life
In brief
Patient-reported outcome measures (PROMs) are validated tools to reliably measure outcomes highly prioritized by patients, such as health-related quality of life (HRQOL) and symptoms, but the current clinical impact of PROMs is limited by a lack of evidence-based methods to incorporate them into routine care. Symptoms, which are highly prevalent among persons living with chronic kidney disease (CKD), substantially contribute to the reduced HRQOL experienced by this patient population. HRQOL spans several domains of wellbeing affected by disease, including physical, mental, and social health, functionality, and symptoms. Both HRQOL and symptom burden are consistently identified by patients with CKD as top clinical and research priorities. These issues are particularly salient to individuals living with advanced CKD, who suffer significant symptom burden that is often underrecognized and undertreated by nephrology providers, yet is a key factor considered by nephrologists for the timing of dialysis initiation. Randomized controlled trials of patients with other chronic illnesses show that routine assessment of symptoms with PROMs improves symptom burden, patient-provider communication, and HRQOL; yet, standardized approaches to regular symptom monitoring among patients with advanced CKD are lacking. This pilot, randomized trial of a PROM-based intervention for routine symptom reporting by patients with feedback of responses to nephrologists aims to address the lack of data on PROM use for symptom assessment in nephrology care. We will evaluate the implementation (reach, feasibility, and acceptability) and preliminary efficacy of monthly patient report of CKD-related symptoms using the electronic IPOS-Renal questionnaire with supported clinician follow-up for 12 months versus standard of care. This trial will utilize complementary quantitative and qualitative methods to evaluate the implementation of the PROM-based intervention. The results of this pilot study will inform a definitive, cluster-randomized trial on the effect of a PROM-based symptom assessment intervention to improve HRQOL and clinical outcomes among patients living with advanced CKD.
Key facts
- Study ID
- NCT07186218
- Run by
- Massachusetts General Hospital
- People needed
- 70
- Starts
- 2026-06-11
- Expected to finish
- 2030-02-28
- Last updated by the study team
- 2026-06-22
Who can join
Age: 18 and older. Sex: any. Healthy volunteers: not accepted.
You may qualify if…
- Adults (age ≥ 18 years)
- Advanced CKD, defined as at least two measurements of creatinine-based or cystatin C-based eGFR ≤ 30 mL/min/1.73m2 separated by at least 90 days in the preceding 12 months
- Able to provide consent to participate in the study
- Able to read and write in English
- Under the care of a nephrologist at a Mass General Brigham nephrology clinic
You may not qualify if…
- Terminal illness likely to lead to death within 6 months of participation
- Patients receiving dialysis treatment at the time of enrollment or scheduled to start dialysis therapy in the next 4 weeks
- Patients scheduled to receive a kidney transplant in the next 6 months
- Patients having their initial clinic visit (i.e., new to the clinic)
- Cognitive deficits that would preclude understanding of consent form and/or questionnaires
Where it is running
- Mass General Brigham — Boston, Massachusetts, United States (enrolling)
Full record on ClinicalTrials.gov
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