Providing Resources to Enhance Patients' Readiness to Make Decisions About Kidney Disease: Partnering to Break the News, Review All Options, Weigh Pros and Cons (PREPARE NOW)
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Chronic Kidney Disease
- Sponsor
- Duke University
- Enrollment
- 24
- Locations
- 1
- Primary Endpoint
- Initiation of self-care dialysis or receipt of transplant
- Status
- Completed
- Last Updated
- 7 years ago
Overview
Brief Summary
This study evaluates the effectiveness of patient educational materials (a book and DVD) to help patients with chronic kidney disease make early, shared, and informed decisions about kidney replacement therapy. Half of the participants will receive the educational materials and half will receive usual care from their doctors.
Detailed Description
The investigators will study the effectiveness of patient educational materials (a book and DVD, called the PREPARED materials) to help patients with chronic kidney disease make early, shared, and informed decisions about kidney replacement therapy. Half of the participants will receive the PREPARED materials and half will receive usual care from their doctors. PREPARED materials feature patients and their families discussing the pros and cons of different treatment options for kidney failure. The investigators will randomly assign patients already under the care of a nephrologist to receive the video and book or to receive their usual nephrology care. They will measure the degree to which patients in either study arm are prepared for kidney failure treatment at follow up.
Investigators
Eligibility Criteria
Inclusion Criteria
- •18 years or older
- •English speaking
- •Advanced kidney disease defined as an eGFR \< 20 mL/min/1.73m2 at their last clinical appointment with their nephrologist
- •Have not initiated a Renal Replacement Therapy
Exclusion Criteria
- •Cannot speak English
- •Have initiated Renal Replacement Therapy
Outcomes
Primary Outcomes
Initiation of self-care dialysis or receipt of transplant
Time Frame: 90 days after randomization
Among the participants initiating renal replacement therapy (RRT) during follow up, the proportion who initiate self-care dialysis (peritoneal dialysis or home hemodialysis) or receive a transplant.
Use of permanent vascular access
Time Frame: 90 days after randomization
Proportion of patients achieving initiation of RRT with a permanent vascular access.
Emergent dialysis initiation
Time Frame: 90 days after randomization
Proportion of patients initiating dialysis urgently in the Emergency Room (versus planned initiation).
Transplant evaluations, waiting list placement
Time Frame: 90 days after randomization
Proportion of patients achieving receipt of transplant evaluations, or placement on the kidney transplant waiting list prior to initiation.
Blood pressure control at RRT initiation
Time Frame: 90 days after randomization
Proportion of patients achieving blood pressure control (systolic blood pressure \<130mmHg and diastolic blood pressure \<80mmHg) at each visit prior to RRT initiation or completion of study follow up.
Anemia management
Time Frame: 90 days after randomization
Proportion of patients with anemia treated to recommended levels (hemoglobin 10g/dl to 12g/dl) at each visit prior to RRT initiation or completion of study follow up.