The effects of cognitive behavioural therapy on depression and quality of life in patients with maintenance haemodialysis: a systematic review

Abstract

Background: Depression is highly prevalent among Haemodialysis (HD) patients and is known to results in a series of adverse outcomes and poor quality of life (QoL). Although cognitive behavioural therapy (CBT) has been shown to improve depressive symptoms and QoL in other chronic illness, there is uncertainty in terms of the effectiveness of CBT in HD patients with depression or depressive symptoms. Methods: All randomised controlled trials relevant to the topic were retrieved from the following databases: CINHAL, MEDLINE, PubMed, PsycINFO and CENTRAL. The grey literature, specific journals, reference lists of included studies and trials registers website were also searched. Data was extracted or calculated from included studies that had measured depression and quality of life using valid and reliable tools-this included mean differences or standardised mean differences and 95% confidence intervals. The Cochrane risk of bias tool was used to identify the methodological quality of the included studies. Results: Six RCTs were included with varying methodological quality. Meta-analysis was undertaken for 3 studies that employed the CBT versus usual care. All studies showed that the depressive symptoms significantly improved after the CBT. Furthermore, CBT was more effective than usual care (MD = − 5.28, 95%CI − 7.9 to − 2.65, P = 0.37) and counselling (MD = − 2.39, 95%CI − 3.49 to − 1.29), while less effective than sertraline (MD = 2.2, 95%CI 0.43 to 3.97) in alleviating depressive symptoms. Additionally, the CBT seems to have a beneficial effect in improving QoL when compared with usual care, while no significant difference was found in QoL score when compared CBT with sertraline. Conclusions: CBT may improve depressive symptoms and QoL in HD patients with comorbid depressive symptoms. However, more rigorous studies are needed in this field due to the small quantity and varied methodological quality in the identified studies.

Sequential administration of pemetrexed and cisplatin reprograms tumor immune microenvironment and potentiates PD-1/PD-L1 treatment in a lung cancer model

“…Patients with long-term treatment have greater cumulative toxicity and poorer quality of life, which may affect the efficacy and benefit. 20 In addition, due to poor patient tolerance, the proportion of patients who can receive more than four cycles of treatment is low, which affects the possible survival benefits of continuous treatment and limits the development effect of maintenance therapy. 21 Toxicity and adverse reactions caused by first-line platinum-containing drugs are usually caused by platinum drugs.…”

Examining the Acceptability and Feasibility of the Compassionate Mindful Resilience (CMR) Programme in Adult Patients with Chronic Kidney Disease: The COSMIC Study Protocol

“…A sample size of 75 will have 95% power to detect a difference in the primary outcome measure of 3 [ 52 ], assuming the common standard deviation is 6 [ 52 ], using a paired t-test with a 0.05 two-sided significance level, whilst also allowing for a 20% attrition rate. The aim is to recruit 75 participants to the study to account for a higher rate of attrition expected of the population and intervention [ 53 , 54 ]. Based on this calculation, the sample size of 75 is expected to be sufficient to detect a difference minimal clinically important difference across the outcome measures.…”

“Is It Removed During Dialysis?”—Cognitive Dysfunction in Advanced Kidney Failure—A Review Article

“…The combined use of both cognitive behavioral therapy (CBT) and the SSRI sertraline are recommended in treating symptoms of depression—extrapolated from evidence from in the general population ( 82 ). There are data to support use of CBT in kidney failure ( 83 ) but attempts to identify a beneficial antidepressant to improve mood are yet to be conclusive ( 84 , 85 ). Further, it remains unclear if cognitive function would be improved in people requiring KRT.…”