Improving Kidney Therapy Decision-Making for Older People With Advanced Chronic Kidney Disease (CKD)
University of Rochester
Summary
The investigators are conducting a study to see which program better helps older patients with kidney disease choose their treatment. Investigators are also investigating if either program can reduce the number of hospital or emergency room visits in the first 6 months of the study, as well as potentially improve end-of-life care for older adults. Half of the participants will receive Program A, while the other half will receive Program B. Investigators will compare the two groups to see which participants feel better prepared about their kidney therapy decisions, experience improved end-of-life care, and have fewer emergency room visits and hospital admissions. Participants in Program A will receive information from the National Kidney Foundation and meet with a kidney therapy educator. Participants in Program B will get information about kidney disease treatment and meet with a decision-support specialist who's an expert in decision-making.
Description
Older adults ≥75 years represent the fastest-growing population to initiate dialysis in the US; despite the life-altering effects of dialysis on quality of life, dialysis is often presented as a default without considering patient preferences, prognosis, and alternative options such as conservative kidney management. This study will test the first palliative care intervention for older patients with advanced chronic kidney disease to improve the kidney therapy decision-making process. This research not only has the potential to help thousands of older patients with advanced chronic kidney dise…
Eligibility
- Age range
- 75+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Age ≥ 75 years old * Has advanced kidney disease with kidney function less than 30% * Speaks English * Has not yet made a dialysis decision Exclusion Criteria: * Has already decided on dialysis or active medical care without dialysis. * Has already been seen by a Palliative Care (PC) clinician for kidney-related issues or is enrolled in hospice * Currently on dialysis * Unable to provide informed consent or complete verbally administered surveys due to health, sensory, or cognitive impairment.
Interventions
- BehavioralProgram A
Subjects in the Control group will receive 1) National Kidney Foundation information, and 2) support from a kidney therapy educator.
- BehavioralProgram B
Subjects in the intervention group will receive 1) a video and paper decision aid, and 2) coaching from a decision support specialist. The visits will be aimed at supporting patients with kidney therapy decision-making.
Locations (5)
- UR Medicine Nephrology - Strong WestBrockport, New York
- Nephrology Clinic - Thompson Professional BuildingCanandaigua, New York
- Nephrology Clinic - St. James Medical Office BuildingHornell, New York
- Highland HospitalRochester, New York
- University of Rochester Medical CenterRochester, New York