HARMONY
A shared decision-making dashboard for fluid management in haemodialysis.
A transnational feasibility trial (Austria, Ireland, Scotland) integrating routinely collected dialysis data with patient-reported symptoms to enable patient-centred fluid management decisions.
Sign in to the dashboardStudy Rationale
Fluid status in haemodialysis is strongly associated with acute symptoms, hospitalisation, and cardiovascular mortality. Despite technological advances, routine fluid management practice — target weight estimation and interdialytic weight gain control — has changed little in decades. HARMONY frames fluid management as a complex intervention requiring systems-level support: integrating routinely collected dialysis data with patient-reported symptoms to enable truly shared, patient-centred decisions. The intervention design is underpinned by Social Cognitive Theory, drawing on established behaviour-change mechanisms related to self-efficacy, feedback, and shared decision-making.
Study Objectives
Primary Objective
To assess the feasibility of conducting a pragmatic, multicentre, cluster randomised trial of data-enabled shared decision-making for fluid management in haemodialysis.
Secondary Objectives
- i.Estimate signals of effect on intradialytic hypotension
- ii.Characterise adherence to the platform by patients and clinicians
- iii.Describe data completeness and process metrics to refine the intervention and trial procedures
- iv.Assess quality of life status
- v.Evaluate shared decision-making (NICE framework survey)
Platform Interface
Patient and clinician views designed for use at the dialysis chair.
HARMONY Study · Week 3/12
Hello, HMY-0042!
💧 How do you feel today?
General wellbeing / fluid balance
🥤 How strong is your thirst?
⚖️ Do you feel fluid overloaded?
⏱️ How long did your recovery after dialysis take?
Time until you felt recovered after the last session
MWF Morning · Week 3
Shift Dashboard
HMY-0042
HMY-0017
HMY-0091
Enter PROM▼HMY-0055
Enter PROM▼Study Design
Prospective, multicentre, cluster randomised, open-label, waitlist-controlled feasibility trial. Clusters (dialysis centres) are randomised 1:1 to intervention or waitlist control. Centres randomised to intervention receive 12 weeks of exposure to the fluid dashboard web application. Control centres receive standard of care for 12 weeks before crossing over to the intervention. The waitlist-controlled design minimises contamination between clinicians and patients while ensuring all centres ultimately receive the platform.
Patient-Reported Outcomes
Patients log fluid status, thirst, and recovery time at every session via a simple large-touch interface.
Clinical Monitoring
Nursing staff enter weight, IDWG, and blood pressure. Trend charts support clinical decision-making.
Feasibility Tracking
Study coordinators monitor participation rates, data completeness, and PROM trends across the 12-week period.