Background

SWIFT is the Symptom monitoring WIth Feedback Trial, this trial is being run by Professor Rachael Morton from the University of Sydney and the NHMRC Trials Centre in Sydney and ANZDATA in Adelaide.

Adults who receive haemodialysis treatment for kidney failure suffer from many problems (symptoms) including tiredness, pain, itching, sleep problems, depression and have reduced quality of life1. About 2 million people worldwide, including 13,000 Australians are treated with haemodialysis. This costs about $1.1 billion per year across Australia. People on haemodialysis also report poor health. Only around 60% of full health. Survival for people who remain on dialysis for 5 years is around 50%, which is lower than all cancers combined2.

 An important problem is that standard dialysis care does not focus on outcomes important to patients like quality of life or symptoms; instead the focus is on managing amounts of urea, potassium, phosphate in a patient’s blood. This has led to missed opportunities to help and improve symptom management and overall quality of life. New information from other areas showed symptom monitoring may not only improve quality of life, but also improve overall survival2. SWIFT will aims to show this in a haemodialysis patients.

Symptoms haemodialysis patients experiencePercentage of people with symptom (%)
tiredness71%
itching55%
constipation53%
anorexia49%
pain47%
sleep problems44%
1Murtagh FE et al. Adv Chronic Kidney Dis. 2007.14(1):82-99.

Table 1. Symptoms in adults with kidney failure

Aim

SWIFT wants to know if symptom monitoring with feedback to nurses, kidney doctors and patients, improves health-related quality of life. SWIFT will also test if collecting information about symptoms with a tablet computer is cost effective.

Pilot Study

An Australian Pilot study was run between September 2019 and March 2020.

The Pilot study showed that patients and nurses found the tablets easy to use. Patients, nurses and kidney doctors also felt that collecting this information was valuable to the wellbeing of haemodialysis patients. The pilot study also showed that we could run a larger registry trial.

What will I have to do if I want to be involved?

If your haemodialysis unit is involved in SWIFT, they will be in group 1 or group 2. You will be asked to complete a couple of surveys on a tablet computer.

Group 1

If the haemodialysis unit is in group 1, participants will be asked to complete the EQ-5D-5L and SONG HD Fatigue surveys, every 6 months for one year. These questionnaires take about 5 minutes to complete. At the 12 months, some participants will also be asked for some questions about what they thought about the trial.

Group 2

If the haemodialysis unit is in group 2, participants will be asked to complete the IPOS Renal surveys every 3 months and the EQ-5D-5L +SONG HD Fatigue surveys every 6 months. They take about 10 minutes to complete each time. The completed IPOS Renal surveys will be sent to the dialysis nurses and each patient’s kidney doctor who will be asked to follow up symptoms at the next appointment. At the 12 months, some participants will also be asked for some questions about what they thought about the trial.

How many people do we need for the trial?

We are would like to include about 3000 haemodialysis patients from 160 centres around Australia and New Zealand. The trial will begin in October 2020 in NSW.

Funding: NHMRC Project grant #1159051, KHA 2018-RM, NHMRC TRIP Fellowship #1150989, University of Sydney Robinson Fellowship

References:

1Murtagh FE et al. Adv Chronic Kidney Dis. 200714(1):82-99; 2Basch E et al. JAMA. 2017;318(2):197-198.

Conducted in collaboration with: