Challenges in psychosocial research in renal populations

Abstract This chapter provides an overview of the many challenges experienced in trying to conduct psychosocial research in patients with renal disease. In this context, psychosocial research is meant to include both research on treatments for comorbid psychiatric illnesses and behavioral interventions targeting symptoms experienced by patients with advanced renal disease, regardless of the symptoms’ psychiatric or medical etiology. The chapter highlights 10 challenges in conducting these types of research: 1. Buy-in from the nephrology research community 2. Complexity of clinical trials 3. Identifying patients of interest 4. Stigma associated with some psychiatric diagnoses 5. Accessibility of mental health treatments 6. Reluctance regarding medications 7. Significance of outcome measures 8. Lack of validation of PROs 9. Challenges to completion of research assessments 10. Response bias A discussion of each of these challenges is followed by suggestions regarding how to best effectively address, avoid, or mitigate them. While there is extra complexity in designing and executing psychosocial clinical trials in nephrology, the need for high-quality studies is urgent, and the effect of these trials on clinical care can be paradigm shifting.