Automated Digital Counseling Program (ODYSSEE-Kidney Health): A Pilot Study on Health-Related Quality of Life

Key Points Feasibility of implementing an automated, scalable, digital self-care program for patients with CKD was established. The primary outcome of improvement in health-related quality of life improved with the ODYSSEE-Kidney Health program. A dose relationship was shown between program engagement tertile and improvement in 4-month outcomes. Background In-person counseling programs promote self-care behavior and health-related quality of life (HRQoL). ODYSSEE-Kidney Health (pr O moting health with D igitall Y based coun S eling for S elf-care b E havior and quality of lif E ; ODYSSEE-KH) is an automated, scalable, digital counseling program for patients with CKD. This open-label, single-arm pilot study tested the efficacy potential of the ODYSSEE-KH program to improve HRQoL in patients with CKD. Methods Adults with categories G3b to 5d CKD were recruited from nephrology clinics in Toronto, Canada. Patients ( N =29) received access to the ODYSSEE-KH program in conjunction with usual care. Generalized linear models and pairwise comparisons of mean change scores were conducted to assess the primary outcome: Mental Component Score (MCS) of the Kidney Disease Quality of Life–Short Form instrument. Secondary outcomes included the MCS Mental Health Scale, 36-Item Kidney Disease Quality of Life–Short Form, Generalized Anxiety Disorder Scale, Patient Health Questionnaire for depression, Enhancing Recovery in Coronary Heart Disease Social Support Instrument, and 3-Item Revised University of California, Los Angeles (UCLA) Loneliness Scale. Results The mean age of the patients was 53.5 years (SD=18.3); 35% were women; 56% were White; 93% had completed ≥postsecondary education; patients came from the Multi-Care Kidney Clinic ( n =9), Home Peritoneal Dialysis Unit ( n =12), and Home Hemodialysis Unit ( n =8); and 24 participants completed the 4-month end-of-study questionnaires. Outcomes were assessed according to tertiles of program log-on minutes: median (range)=67 (62–108), 212 (119–355), and 500 (359–1573) minutes, respectively. Patients in the highest tertile of engagement showed significant improvements on the MCS versus the moderate tertile group ( P = 0.01). Significant dose-response associations were observed for the MCS Mental Health Scale ( P < 0.05), KDQoL Burden on Kidney Disease ( P < 0.01), KDQoL Effect of Kidney Disease on Everyday Life ( P < 0.01), aggregated KDQoL Summary Scale ( P < 0.05), Generalized Anxiety Disorder Scale ( P < 0.01), Patient Health Questionnaire for Depression ( P < 0.05), Enhancing Recovery in Coronary Heart Disease Social Support Instrument ( P < 0.01), and 3-Item Revised UCLA Loneliness Scale ( P < 0.01). Conclusion The ODYSSEE-KH program demonstrated feasibility as an automated, scalable, digital self-care program for patients with CKD. There is evidence of its efficacy potential to improve HRQoL. Further evaluation with a larger sample is warranted.