Energy conservation to manage fatigue: a pragmatic cluster randomised control trial

Energy conservation to manage fatigue: a pragmatic cluster randomised control trial

Background: Fatigue is a common and debilitating symptom to those receiving haemodialysis (HD). Energy conservation is a strategy that has been used to manage fatigue in other chronic conditions such as multiple sclerosis, cancer, and stroke, however, such evidence is lacking in the HD population.

Aims: To test the effectiveness of an energy conservation education program on fatigue in the HD population.

Methods: A pragmatic cluster randomised controlled trial recruited 126 participants on HD and randomised into intervention and the control groups based on HD shifts. The intervention group received four face-to-face structured energy conservation education (ECE) sessions during HD treatment plus usual care over 12 weeks. The control group received usual care. The fatigue symptom inventory (FSI) was used to measure fatigue at baseline, weeks 4, 8, and 12 for both groups. It measures 4 aspects of fatigue (severity, interference, fatigue days, and percent of days being fatigued). Intention-to-treat analysis was used.

Results: At baseline, there were no significant differences in demographic, clinical, or FSI scores between groups. Total fatigue severity was significantly reduced in the intervention group from baseline to week 12 compared to the control (p < .001). Similar findings were observed for fatigue interference (p < .001), fatigue days (p < .001) and percent of days being fatigued (p < .001).

Conclusion: The ECE program, designed to be delivered by nurses during HD treatment, was effective in managing fatigue in an HD population. It could be incorporated into the routine care of people in dialysis units.

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