Chronic Kidney Diseases
Conditions
Brief summary
The aim of this study is to evaluate the impact of a web-based dialysis decision support tool on decisional conflict, and values-treatment concordance and other decisional outcomes in individuals with advanced chronic kidney disease, and to assess the tool's acceptability and usability.
Detailed description
This study employs a pre-post design to assess the impact of a web-based dialysis decision support tool on patients with advanced chronic kidney disease and their caregivers. Participants will complete baseline surveys assessing demographics, knowledge of kidney failure treatments, and decisional conflict during a nephrology clinic visit. Following the visit, participants will access the decision support tool, with follow-up support provided by the study coordinator. One to four weeks after the baseline visit, participants will complete follow-up surveys to re-evaluate knowledge, decisional conflict, values-treatment concordance, and the quality of shared decision-making. Additionally, telephone interviews will be conducted to explore participants' understanding of treatment options and gather feedback on the decision support tool.
Interventions
BEHAVIORALWeb-based dialysis decision support tool
The intervention in this study is the Kidney Care Roadmap, a web-based dialysis decision support tool designed to assist patients with advanced chronic kidney disease and their caregivers.
Sponsors
VA Palo Alto Health Care System
Study design
Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Intervention model description
This is a non-randomized controlled trial using historical control as a comparator. It involves comparing outcomes from a group of participants receiving the current intervention with outcomes from a previously treated group (historical control) that did not receive the intervention.
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Age >=65 2. Estimated GFR <25 ml/min/1.73m2 3. English speaking 4. Not a candidate for kidney transplant based on nephrologist assessment. Family/caregiver inclusion criteria: 1. age >=21 2. English speaking
Exclusion criteria
a. Patients with cognitive impairment will be excluded; however their family member or caregiver is eligible to participate.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Treatment choice | 1 month | Proportion of patients who are undecided about treatment choice. |
| Values treatment concordance | 1 month | Change in values treatment concordance. |
| Confidence in treatment decision | 1 month | Confidence in kidney failure treatment decision |
| Decisional Conflict Scale (DCS) | 1 month | Change in the decisional conflict scale (DCS) score from baseline to follow-up. Scores range from 0 \[no decisional conflict\] to 100 \[extremely high decisional conflict\]. |
Countries
United States
Outcome results
None listed