Project Title:
Evaluating the impact of a psychosocial intervention (Optimal Health Program) on anxiety, depression and quality of life for people with chronic kidney disease who are commencing dialysis (A Pilot Study)

Amount funded by beyondblue:
$131,523 over 24 months

Principal Investigator:
Associate Professor Robyn Langham

Lead Organisation:
St. Vincent's Hospital Melbourne

Associate Investigators:
Ms Monica Gilbert (St Vincent's Hospital Melbourne)
Dr Mike Salzberg (St Vincent's Mental Health Service)
Associate Professor Danny Liew (University of Melbourne)
Professor David Castle (University of Melbourne, St Vincent's Hosptial)
Dr James Chamberlain (St Vincents Hospital)

Project Background:
In Australia the incidence of chronic kidney disease (CKD) is increasing rapidly such that between 2006 and 2010 the number of Australians aged 25 and over with end-stage kidney disease (ESKD) will almost double1. The treatment of ESKD requires initiation of renal replacement therapy (RRT), either in the form of kidney transplantation or dialysis. Dialysis is a challenging experience for most patients, especially in the first year with high economic and personal costs to patients and their families, and considerable economic and planning implications for the health care system5. However, dialysis is a lifesaving treatment that if well managed affords the individual the chance of receiving a kidney transplant and of engaging in more normal life activities. It is of concern therefore that a recent study found that the kidney rejection rate is doubled in patients who are depressed. Thus better management of psychological comorbidity during the dialysis phase may have benefits also for the later treatment trajectory of the patient, including transplantation.

Project Objectives:
The intervention to be used is termed the DIALYSIS OPTIMAL HEALTH PROGRAM (DOHP), to be adapted from a prior intervention - the OPTIMAL HEALTH PROGRAM (OHP) - that we have shown to have considerable efficacy in patients with chronic relapsing mood disorder, schizophrenia and substance use. OHP is an 8 week, structured intervention that includes assessment, treatment manuals, patient resources and training for clinicians. Though developed and tested in mental health settings, OHP was designed to address both physical and psychosocial dimensions of the health of the chronically mentally ill, who are known to have very high rates of medical comorbidity and premature mortality. The project aim is to gain logistical knowledge to inform the design of a definitive randomised controlled trial of the DIALYSIS OPTIMAL HEALTH PROGRAM for management of depression and anxiety in patients in the first year of renal dialysis.