Randomized trial of an uncertainty self-management telephone intervention for patients awaiting liver transplant.

The self-management group completed fewer calls than planned and fewer full six-call courses than the education group. The dose may have been too low. Participants had moderate to low levels of uncertainty, depressive symptoms, and anxiety at baseline. There was little room for improvement. The control group was active liver disease education delivered by the same interventionists. The study tested relative benefit, not effect versus usual care. Telephone delivery may not provide the same support as face-to-face sessions. Prior face-to-face programmes used longer sessions. Dropout was related to transplant, death, withdrawal, or scheduling. Missing outcomes were imputed, so results depend on statistical assumptions. No adjustment for multiple comparisons was made.

The study was funded by the National Institute of Nursing Research through a P01 Center. The supplied text does not state commercial sponsor funding or author conflicts of interest.

Do not conclude that telephone self-management is ineffective for patients waiting for liver transplant. The trial compared it with active liver disease education, both groups received supportive calls, and the self-management group completed fewer sessions, so a specific effect of the self-management content may be hidden.