A feasibility study of behavioural activation for haemodialysis: The BEACH study protocol

Introduction: People with kidney failure receiving haemodialysis experience significantly high rates of depression. However, there is a lack of evidence on how to treat depression in this population. A significant barrier to effective treatment is the high treatment burden of haemodialysis, which makes additional appointments prohibitive. Behavioural activation (BA) is an evidence-based brief therapy for depression that has been delivered in a variety of different clinical settings. However, it has not previously been evaluated in the haemodialysis setting. Methods: This study aims to evaluate the feasibility and acceptability of a cluster randomised controlled trial (cRCT) of intradialytic BA for people with kidney failure. The study consists of three main components: A pilot cRCT, where we will recruit 52 people who are receiving haemodialysis and experiencing symptoms of depression across two sites. Patients will be cluster-randomised to either BA or usual care and will be followed up for three months; a qualitative process evaluation using semi-structured interviews to explore the experiences of patients, healthcare professionals and carers; and a feasibility economic evaluation exploring the feasibility of collecting healthcare resource use data. Results: Key findings will include the feasibility of screening and recruiting participants, participant retention, completion of clinical outcome measures, and the acceptability of the intervention. Conclusion: If feasible, the next step will be to conduct a definitive, adequately powered cRCT to determine the effectiveness of the intervention in this population, so that we can improve the identification and management of depression for people with kidney failure.