Comparing Two Ways to Monitor Symptoms for Adults on Hemodialysis Using the SMaRRT-HD System Versus Usual Care

What this Trial Is About

This research aims to compare two methods of symptom monitoring in adults with End Stage Kidney Disease undergoing hemodialysis. The study evaluates whether using the SMaRRT-HD electronic patient-reported outcome measure system with supported clinician follow-up can reduce symptoms and improve communication between patients and care teams. Approximately 2400 patients from up to 36 diverse dialysis clinics in the US will participate, with clinics randomly assigned to either SMaRRT-HD or Usual Care. Participants in clinics using the SMaRRT-HD system will report symptoms on tablets through an electronic patient-reported outcome measure, and clinicians will receive alerts, guidance, and symptom reports to support follow-up care. This system is used alongside the usual symptom monitoring. Clinics assigned to Usual Care will continue their standard symptom monitoring through clinical interactions and a mandated health-related quality of life survey. The study period for the SMaRRT-HD system lasts 12 months. During the study, researchers will assess symptom severity, quality of life, fatigue, pain interference, anxiety, depression, healthcare engagement, hospitalizations, mortality, and dialysis session attendance at baseline, 6 months, and 12 months. Implementation outcomes such as adherence to symptom reporting, clinician follow-up, and acceptability of the system will also be evaluated. Hospitalizations and mortality will be tracked for 18 months total. Participants will be monitored throughout the active study period to understand the impact of symptom monitoring methods on their care.

Symptom Monitoring in Hemodialysis