Medicine

Patients help design digital therapy for coping with kidney disease

AI Insight

Researchers developed iADJUST, a digitally delivered psychological intervention designed to help patients adjust to living with chronic kidney disease (CKD). The six-session program, delivered over 12 weeks with therapist support, was created using a systematic approach combining psychological theory, research evidence, and input from CKD patients. It targets specific cognitive and behavioral mechanisms such as illness uncertainty, catastrophic thinking, self-criticism, and activity withdrawal that interfere with adjustment to the disease.


Psychological distress is common in CKD patients and negatively affects quality of life and clinical outcomes, yet psychological support is rarely integrated into kidney care. This theory-based digital intervention could provide accessible, scalable psychological support specifically tailored to the challenges CKD patients face in managing their condition.


⚠️ Preprint – Noch nicht peer-reviewed

Dieser Artikel wurde noch nicht von unabhängigen Experten begutachtet. Die Ergebnisse sind vorläufig und sollten mit Vorsicht interpretiert werden.

Background: Psychological distress is common in chronic kidney disease (CKD) and is associated with reduced quality of life, treatment non-adherence, and worse clinical outcomes. Distress in CKD is also linked to difficulties adjusting to the demands of illness management. Despite this, psychological support remains inconsistently integrated within kidney care pathways, and existing interventions often lack clear theoretical specification and explicit targeting of mechanisms underpinning adjustment to CKD. Objectives: To describe the systematic development of iADJUST, a theory-informed patient co-designed digital psychological intervention targeting key cognitive and behavioural mechanisms involved in adjustment to CKD. Methods: Intervention development was guided by the Medical Research Council framework for complex interventions. A structured, iterative process integrated empirical evidence, psychological theory, and patient and public involvement and engagement. The Common-Sense Model of Self-Regulation and cognitive behavioural theories informed the identification of modifiable maintaining mechanisms associated with adjustment to CKD. Intervention components were mapped onto these mechanisms and refined through co-design with people living with CKD. Results: iADJUST is a six-session self-guided digital psychological intervention delivered over 12 weeks and supplemented by therapist contact. The intervention targets illness-related uncertainty, fatigue-related activity dysregulation, catastrophic what-if thinking, self-critical evaluation, and behavioural withdrawal. It integrates psychoeducation, cognitive and behavioural strategies, maintenance planning, and elements from acceptance and commitment therapy and compassion-focused approaches. Content is delivered through video, audio, and guided tasks and activities. Conclusion: iADJUST provides a theory-informed, evidence-based psychological intervention for CKD explicitly mapping intervention components to maintaining cognitive and behavioural mechanisms implicated in adjustment. Feasibility evaluation is underway.

Source: Development of iADJUST: a theory-informed, patient co-designed digital psychological intervention for adjustment in chronic kidney disease