The E-GOAL study: E-health in chronic kidney disease

INTERVENTION: All patients will fill out a web‐based screening questionnaire. Patients who fulfill the criteria of heightened psychological distress and related life style problems (that is, who insufficiently meet nephrology guidelines for a healthy life style) will be randomized to either the control or the intervention condition. Patients in the control group will receive a feedback form about the results of the screening and further receive regular care. ln the intervention group, patients additionally receive (1) an intake with a psychologist (e‐coach) to interpret and discuss results of the screening as displayed in the personal profile chart, make shared decisions on personal treatment goals and how to monitor progress on these goals, (2) a brief and tailored e‐coach intervention based on cognitive‐behavioral therapy to treat psychological distress, overcome barriers and promote facilitators for healthy life style behaviors for a period of approximately 3 months, and (3) a consultation with the psychologist after completing the e‐coach trajectory for evaluation and long‐term goals. Treatment will be guided by a psychologist who is specifically trained in the tailored cognitive‐behavioral protocol. CONDITION: Chronic kidney disease (CKD), E‐health, health behavior change, psychological distress, life style PRIMARY OUTCOME: The primary study outcome is psychological distress, assessed with a questionnaire by a combination of the Generalized Anxiety Disorder‐7 (GAD‐7) and the Patient Health Questionnaire‐9 (PHQ‐9). SECONDARY OUTCOME: 1. Personal goal achievement (that is, meaningful improvements on the areas of interest to the patient, e.g., healthy life style behavior, coping with fatigue, pain, negative mood, and social functioning); ; 2. Changes in disease‐specific self‐efficacy and self‐management; ; 3. Changes in mental and physical health‐related quality of life. ; INCLUSION CRITERIA: • Under medical treatment by an internist‐nephrologist • Chronic kidney disease with an eGFR 20‐89 ml/min/1.73m2 • ≥ 18 years of age • Sufficient command of the Dutch language • Able to give informed consent • Access to a computer or tablet with internet • Heightened psychological distress as indicated by questionnaires: Mild to moderately severe depression scores and/or mild to moderate anxiety scores • At least one of the nephrology guidelines for healthy life style behavior is not met