American Medical Association (AMA)
JAMA Internal Medicine
,  volume 185 ,  issue 2 ,  pages 197

Pain Coping Skills Training for Patients Receiving Hemodialysis

Laura M. Dember 1, 2
, 
Jesse Y. Hsu 2
, 
Rajnish Mehrotra 3
, 
Kerri L Cavanaugh 4
, 
Sahir Kalim 5
, 
David M. Charytan 6
, 
Michael J. Fischer 7, 8, 9
, 
Manisha Jhamb 10
, 
Kirsten L. Johansen 11, 12
, 
William C. Becker 13, 14
, 
Bethany Pellegrino 15
, 
Nwamaka D. Eneanya 1, 16
, 
Sarah J. Schrauben 1, 2
, 
Patrick H. Pun 17, 18
, 
Mark L. Unruh 19
, 
Benjamin J. Morasco 20, 21
, 
Mansi Mehta 6, 22
, 
Nobuyuki Miyawaki 23
, 
Jeffrey Penfield 24, 25
, 
Leah Bernardo 2
, 
Carrie E. Brintz 26
, 
MARTIN D. CHEATLE 27, 28
, 
Ardith Z. Doorenbos 29, 30
, 
Alicia A. Heapy 14, 31
, 
Francis J. Keefe 32
, 
Erin E. Krebs 33, 34
, 
Natalie Kuzla 35
, 
Sagar U. Nigwekar 5
, 
Rebecca J. Schmidt 15
, 
Jennifer L. Steel 36, 37, 38
, 
James B. Wetmore 11, 12
, 
David M. White 39
, 
PAUL L. KIMMEL 40
, 
Daniel Cukor 41, 42
, 
Melissa Adams 43
, 
Stephany Almonte-Then 43
, 
Chigozie Amonu 43
, 
Lisa Anderson 43
, 
Adamaris Argega Leon 43
, 
Christos P Argyropoulos 43
, 
Elena Ashley 43
, 
Monica Bajana Meza 43
, 
Nisha Bansal 43
, 
Monica Barbosa 43
, 
Ted Barrell 43
, 
Gavin B Bart 43
, 
Amber Barton 43
, 
Scott Beach 43
, 
Levi Beeks 43
, 
Justin M. Belcher 43
, 
Nathaniel Berman 43
, 
DeVitra Berry 43
, 
Elenore P. Bhatraju 43
, 
Nicholas Bishop 43
, 
Christopher Blazes 43
, 
Andrew M. Busch 43
, 
Sarah Cameron 43
, 
Monica Cardona 43
, 
Victoria Casilli 43
, 
Miri Cazes 43
, 
Gabriela Chacon Palma 43
, 
Katy Chalamidas 43
, 
Sobaata Chaudry 43
, 
Nelson Chen 43
, 
Ines Chicos 43
, 
Carlyn Clark 43
, 
Deza'Rae Collins 43
, 
Lynda Connelly 43
, 
Blanca Contreras 43
, 
Adrian Cosmin 43
, 
Susan T Crowley 43
, 
Cheryl Dalton 43
, 
Jane Dirks 43
, 
Stephanie Donahue 43
, 
Paula Dutka 43
, 
Veronica Dyer 43
, 
Oluoma Edeh 43
, 
David A. Edwards 43
, 
Dawn P. Edwards 43
, 
Kome Ekor 43
, 
Denise Esserman 43
, 
Caroline G. Falker 43
, 
Luke Farkas 43
, 
John T. Farrar 43
, 
Sabrina Felson 43
, 
Yasmine Flores 43
, 
Daniela Fraticelli Ortiz 43
, 
George Garcia 43
, 
Lindsay Gear 43
, 
Ana Geibel 43
, 
CHERYL GILMARTIN 43
, 
David S. Goldfarb 43
, 
Keith S. Goldfeld 43
, 
Amanda J Goldstein 43
, 
Anna Gong 43
, 
Candace Grant 43
, 
Robert E Grindstaff 43
, 
Erik Guajardo 43
, 
Cameron Guy 43
, 
Megan Hamm 43
, 
Jenika Hammond 43
, 
Khritian Harris 43
, 
Sara Hoffman 43
, 
Christopher Holden 43
, 
Heather Howell 43
, 
T. Alp Ikizler 43
, 
Steven Joffe 43
, 
Jonah Joffe 43
, 
Sydney Johnson 43
, 
Eshika Kalam 43
, 
Kyle M. Kampman 43
, 
Colin Keane 43
, 
Grace Kimura 43
, 
Olivia Kirsch 43
, 
Wissam M. Kourany 43
, 
Pragna Krishnamurthy 43
, 
Paula Kubrick 43
, 
Prescious Lacey 43
, 
J. RICHARD LANDIS 43
, 
James P Lash 43
, 
Kaeleb Lazlo 43
, 
Joshua D. Lee 43
, 
James P Lefler 43
, 
Alexander Leon Cupe 43
, 
Stephen Lerner 43
, 
Jane Liebschutz 43
, 
Patricia Lietz 43
, 
Lori Linke 43
, 
Mark B. Lockwood 43
, 
Henry Luo 43
, 
Ashley Macina 43
, 
Angela McCarthy 43
, 
Katherine McDaniels 43
, 
Sophia McLaren 43
, 
Daniel W. McNeil 43
, 
Monya Meinel 43
, 
Valeria Mejia 43
, 
Beza Mengesha 43
, 
Don Merriman 43
, 
Wambua Michael 43
, 
Roger Mims 43
, 
Puneet Mishra 43
, 
Frank Modersitzki 43
, 
Alvin H. Moss 43
, 
Claire Mullins 43
, 
Ursula Munet 43
, 
Kristy O'Connell 43
, 
Uchechukwu Okereke 43
, 
Donna Olejniczak 43
, 
Samuel Opeke 43
, 
Maria Pacheco-Hernandez 43
, 
SHANE PANKRATZ 43
, 
Diane Park 43
, 
Kevin Payne 43
, 
Hadassah Pegues 43
, 
Shanannssa Percy 43
, 
Sarah Pleasant 43
, 
Teresa Purdy 43
, 
Davin Quinn 43
, 
Nina Quintana 43
, 
Kathleen Rice 43
, 
Grace Robinson 43
, 
Christopher Roche 43
, 
Giselle Rodriguez Sosa 43
, 
Gabriel Rudow 43
, 
Rudy Qamhiyeh 43
, 
Jeanette Rutledge 43
, 
Sindi Sanchez 43
, 
Brian Sands 43
, 
Jennifer S Scherer 43
, 
Mary Schopp 43
, 
Brandon Self 43
, 
Amanda J. Shallcross 43
, 
Kimberly Silva 43
, 
Taylor Stallings 43
, 
Christopher S Stauffer 43
, 
Alana D. Steffen 43
, 
Thomas Stewart 43
, 
Susan Stringfellow 43
, 
Lily Sullivan 43
, 
Richard Torres 43
, 
John Torres 43
, 
Greg Trejo 43
, 
Dalila Varela 43
, 
Svetlana Vassilieva 43
, 
Hugo Vilchis 43
, 
Darlene Villareal 43
, 
Joanna Walsh 43
, 
Javaughn Ways 43
, 
Tammy Weidner 43
, 
Melissa Weimer 43
, 
DANIEL E. WEINER 43
, 
Steven D. Weisbord 43
, 
Caroline Wilkie 43
, 
Maryanne Wilkinson 43
, 
Sonya Williams 43
, 
Joel Williams 43
, 
Olivia Wilson 43
, 
Vincent Wood 43
, 
Jonathan G. Yabes 43
, 
Guillermo Zamora 43
, 
Samara Zaniga 43
1
 
2
 
3
 
4
 
5
 
6
 
7
 
8
 
Medical Service, Jesse Brown VA Medical Center, Chicago, Illinois | 
9
 
Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, Hines, Illinois | 
10
 
11
 
Division of Nephrology, Department of Medicine, Hennepin Healthcare, Minneapolis, Minnesota | 
12
 
13
 
14
 
Pain Research, Informatics, Multi-morbidities and Education Center of Innovation, VA Connecticut Healthcare System, West Haven
15
 
16
 
17
 
18
 
Medical Service, Durham VA Medical Center, Durham, North Carolina | 
19
 
20
 
Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon | 
21
 
22
 
VA New York Harbor Healthcare, New York | 
23
 
24
 
25
 
VA North Texas Health Care System, Dallas | 
26
 
27
 
28
 
29
 
30
 
31
 
32
 
33
 
Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota | 
34
 
35
 
36
 
37
 
38
 
39
 
American Association of Kidney Patients, Tampa, Florida | 
40
 
41
 
The Rogosin Institute, New York, New York | 
42
 
43
 
and the HOPE Consortium | 
Publication type: Journal Article
Publication date: 2025-02-01
American Medical Association (AMA)
scimago Q1
wos Q1
SJR: 4.623
CiteScore: 24.7
Impact factor: 23.3
ISSN: 21686106, 21686114
Abstract
Importance

Chronic pain is common among individuals with dialysis-dependent kidney failure.

Objective

To evaluate the effectiveness of pain coping skills training (PCST), a cognitive behavioral intervention, on pain interference.

Design, Setting, and Participants

This multicenter randomized clinical trial of PCST vs usual care was conducted across 16 academic centers and 103 outpatient dialysis facilities in the US. Adults undergoing maintenance hemodialysis and experiencing chronic pain were randomly assigned to PCST or usual care in a 1:1 ratio. Participants were followed in the trial for 36 weeks. Enrollment began on January 4, 2021, and follow-up ended on December 21, 2023.

Interventions

PCST consisting of 12 weekly coach-led sessions via video or telephone conferencing, followed by 12 weeks of daily interactive voice response sessions. Usual care had no trial-driven pain intervention.

Main Outcomes

The primary outcome was pain interference measured with the Brief Pain Inventory (BPI) Interference subscale (score range of 0-10, with higher scores indicating more pain interference). Secondary outcomes included pain intensity, pain catastrophizing, quality of life, depression, and anxiety.

Results

A total of 643 participants (mean [SD] age, 60.3 [12.6] years; 288 [44.8%] female) were randomized, with 319 assigned to PCST and 324 assigned to usual care. At week 12 (primary end point), the PCST group had a larger reduction in the BPI Interference score than the usual care group (between-group difference, −0.49; 95% CI, −0.85 to −0.12; P = .009). The effect persisted at week 24 (between-group difference in BPI Interference score, −0.48; 95% CI, −0.86 to −0.11) but was diminished at week 36 (between-group difference in BPI Interference score, −0.34; 95% CI, −0.72 to 0.04). A decrease in BPI Interference score greater than 1 point (minimal clinically important difference) occurred in 143 of 281 participants (50.9%) in the PCST group vs 108 of 295 participants (36.6%) in the usual care group at 12 weeks (odds ratio, 1.79; 95% CI, 1.28-2.49) and 142 of 258 participants (55.0%) in the PCST group vs 113 of 264 participants (42.8%) in the usual care group at 24 weeks (odds ratio, 1.59; 95% CI, 1.13-2.24). Favorable changes with PCST were also apparent for secondary outcomes of pain intensity, quality of life, depression, and anxiety at weeks 12 and/or 24, as well as for pain catastrophizing at weeks 24 and 36.

Conclusions and Relevance

In this randomized clinical trial of patients undergoing maintenance hemodialysis, PCST had benefits on pain interference and other pain-associated outcomes. While the effect on the overall cohort was of modest magnitude, the intervention resulted in a clinically meaningful improvement in pain interference for a substantial proportion of participants.

Trial Registration

ClinicalTrials.gov Identifier: NCT04571619

Found 
Found 

Top-30

Journals

1
2
3
Clinical journal of the American Society of Nephrology : CJASN
Clinical journal of the American Society of Nephrology : CJASN, 3, 27.27%
Clinical journal of the American Society of Nephrology : CJASN
3 publications, 27.27%
American Journal of Kidney Diseases
American Journal of Kidney Diseases, 2, 18.18%
American Journal of Kidney Diseases
2 publications, 18.18%
JAMA Internal Medicine
JAMA Internal Medicine, 1, 9.09%
JAMA Internal Medicine
1 publication, 9.09%
Journal of Clinical Personalized Medicine
Journal of Clinical Personalized Medicine, 1, 9.09%
Journal of Clinical Personalized Medicine
1 publication, 9.09%
Drugs and Aging
Drugs and Aging, 1, 9.09%
Drugs and Aging
1 publication, 9.09%
Kidney International
Kidney International, 1, 9.09%
Kidney International
1 publication, 9.09%
Kidney360
Kidney360, 1, 9.09%
Kidney360
1 publication, 9.09%
Journal of the American Society of Nephrology : JASN
Journal of the American Society of Nephrology : JASN, 1, 9.09%
Journal of the American Society of Nephrology : JASN
1 publication, 9.09%
1
2
3

Publishers

1
2
3
4
5
Ovid Technologies (Wolters Kluwer Health)
Ovid Technologies (Wolters Kluwer Health), 5, 45.45%
Ovid Technologies (Wolters Kluwer Health)
5 publications, 45.45%
Elsevier
Elsevier, 3, 27.27%
Elsevier
3 publications, 27.27%
American Medical Association (AMA)
American Medical Association (AMA), 1, 9.09%
American Medical Association (AMA)
1 publication, 9.09%
Hans Publishers
Hans Publishers, 1, 9.09%
Hans Publishers
1 publication, 9.09%
Springer Nature
Springer Nature, 1, 9.09%
Springer Nature
1 publication, 9.09%
1
2
3
4
5
  • We do not take into account publications without a DOI.
  • Statistics recalculated weekly.

Are you a researcher?

Create a profile to get free access to personal recommendations for colleagues and new articles.
Metrics
13
Share
Cite this
GOST |
Cite this
GOST Copy
Dember L. M. et al. Pain Coping Skills Training for Patients Receiving Hemodialysis // JAMA Internal Medicine. 2025. Vol. 185. No. 2. p. 197.
GOST all authors (up to 50) Copy
Dember L. M. et al. Pain Coping Skills Training for Patients Receiving Hemodialysis // JAMA Internal Medicine. 2025. Vol. 185. No. 2. p. 197.
RIS |
Cite this
RIS
BibTex |
Cite this
BibTex (up to 50 authors) Copy
@article{2025_Dember,
author = {Laura M. Dember and Jesse Y. Hsu and Rajnish Mehrotra and Kerri L Cavanaugh and Sahir Kalim and David M. Charytan and Michael J. Fischer and Manisha Jhamb and Kirsten L. Johansen and William C. Becker and Bethany Pellegrino and Nwamaka D. Eneanya and Sarah J. Schrauben and Patrick H. Pun and Mark L. Unruh and Benjamin J. Morasco and Mansi Mehta and Nobuyuki Miyawaki and Jeffrey Penfield and Leah Bernardo and Carrie E. Brintz and MARTIN D. CHEATLE and Ardith Z. Doorenbos and Alicia A. Heapy and Francis J. Keefe and Erin E. Krebs and Natalie Kuzla and Sagar U. Nigwekar and Rebecca J. Schmidt and Jennifer L. Steel and James B. Wetmore and David M. White and PAUL L. KIMMEL and Daniel Cukor and Melissa Adams and Stephany Almonte-Then and Chigozie Amonu and Lisa Anderson and Adamaris Argega Leon and Christos P Argyropoulos and Elena Ashley and Monica Bajana Meza and Nisha Bansal and Monica Barbosa and Ted Barrell and Gavin B Bart and Amber Barton and Scott Beach and Levi Beeks and Justin M. Belcher and others},
title = {Pain Coping Skills Training for Patients Receiving Hemodialysis},
journal = {JAMA Internal Medicine},
year = {2025},
volume = {185},
publisher = {American Medical Association (AMA)},
month = {feb},
url = {https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2828284},
number = {2},
pages = {197},
doi = {10.1001/jamainternmed.2024.7140}
}
MLA
Cite this
MLA Copy
Dember, Laura M., et al. “Pain Coping Skills Training for Patients Receiving Hemodialysis.” JAMA Internal Medicine, vol. 185, no. 2, Feb. 2025, p. 197. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2828284.