Using Shared Decision Making to Improve Kidney Transplantation Rates
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 37
- 试验地点
- 3
- 主要终点
- Change in frequency of shared decision-making conversations,
研究概览
简要总结
The goal of this clinical trial is to increase shared decision-making between dialysis providers and patients in order to increase patients' probability of transplantation and to reduce socioeconomic/racial disparities in access to kidney transplantation.
Participants will receive educational material over the course of 4-6 months about different aspects of the kidney transplant and waitlisting process.
详细描述
Kidney transplantation is the preferred treatment choice for patients with end stage kidney disease (ESKD), yet only a small proportion of patients with incident ESKD are counseled about their transplant options. Often, a smaller minority of patients reach the transplant waitlist in a timely manner. Increasing the likelihood of transplantation for patients with ESKD can lead to longer survival, better quality of life, and reduced costs of care.
The kidney transplant and waitlist process is a complex and multi-step process that occurs over an extended period of time. This process involves transitions of care between multiple providers and requires patients to be proactive in their medical evaluations.
This study will deliver educational materials to dialysis care teams and provide quarterly, personalized informational letters to patients, with the aim of increasing shared decision-making between patients and providers by giving them the information needed to initiate conversations about kidney transplantation.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Single Group
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •On a waitlist or undergoing an evaluation at the Columbia University/New York Presbyterian Hospital (CU/NYPH) Transplant Center or at the Cleveland Clinic (CC)
- •Receiving hemodialysis at one of the following dialysis clinics:
- •Fresenius Kidney Care City Dialysis
- •DaVita Kidney Care Haven Dialysis
- •DaVita Melrose Dialysis
- •DaVita Highbridge Dialysis
- •Rogosin Institute East Side Dialysis Unit
- •Rogosin Institute West Side Dialysis Unit
排除标准
- •Speaking a language other than English or Spanish
- •Younger than 18 years of age
结局指标
主要结局
Change in frequency of shared decision-making conversations,
时间窗: Baseline (day 1), post letter 1 (approx 1 month later), post letter 2 (approx 1 month later), post letter 3 ( approx 1 month later), post intervention (approx 4-6 mos total)
Frequency of shared decision-making conversations will be measured by two Yes/No questions on the patient survey using McNemar's test.
Change in donor kidney preferences
时间窗: Baseline (day 1), post letter 1 (approx 1 month later), post letter 2 (approx 1 month later), post letter 3 (approx 1 month later), post intervention (approximately 4-6 mos total)
Patient preferences for kidneys from living donors, kidneys from Hepatitis C positive donors, and kidneys from high KDPI donors will be measured by six Yes/No questions on the patient survey using McNemar's test.
Change in patient knowledge of individual waitlist status
时间窗: Baseline (day 1), post letter 1 (approx 1 month later), post letter 2 (approx 1 month later), post letter 3 (approx 1 month later), post intervention (approx 4-6 months total)
Patient knowledge of individual waitlist status will be measured by one Yes/No question on the patient survey using McNemar's test.
次要结局
- Provider assessment of patient letters, as measured on provider survey(End of intervention/at completion of letter delivery (4-6 months))
- Change in dialysis provider attitudes, as measured on provider survey(Post-educational session, Day 1)
研究者
Sumit Mohan, MD
Professor of Medicine and Epidemiology
Columbia University