A randomized controlled trial protocol testing a decision support intervention for older patients with advanced kidney disease

Brown, Leanne, Gardner, Glenn and Bonner, Ann (2016) A randomized controlled trial protocol testing a decision support intervention for older patients with advanced kidney disease. Journal of Advanced Nursing, 72 5: 1191-1202. doi:10.1111/jan.12921


Author Brown, Leanne
Gardner, Glenn
Bonner, Ann
Title A randomized controlled trial protocol testing a decision support intervention for older patients with advanced kidney disease
Journal name Journal of Advanced Nursing   Check publisher's open access policy
ISSN 1365-2648
0309-2402
Publication date 2016-05
Year available 2016
Sub-type Article (original research)
DOI 10.1111/jan.12921
Open Access Status Not Open Access
Volume 72
Issue 5
Start page 1191
End page 1202
Total pages 12
Place of publication Chichester, West Sussex, United Kingdom
Publisher Wiley-Blackwell Publishing
Collection year 2017
Language eng
Formatted abstract
Aim: To assess the effectiveness of a decision support intervention using a pragmatic single blind Randomized Controlled Trial.

Background: Worldwide the proportion of older people (aged 65 years and over) is rising. This population is known to have a higher prevalence of chronic diseases including chronic kidney disease. The resultant effect of the changing health landscape is seen in the increase in older patients (aged ≥65 years) commencing on dialysis. Emerging evidence suggests that for some older patients dialysis may provide minimal benefit. In a majority of renal units non-dialysis management is offered as an alternative to undertaking dialysis. Research regarding decision-making support that is required to assist this population in choosing between dialysis or non-dialysis management is limited.

Design: A multisite single blinded pragmatic randomized controlled trial is proposed.

Methods: Patients will be recruited from four Queensland public hospitals and randomizd into either the control or intervention group. The decision support intervention is multimodal and includes counselling provided by a trained nurse. The comparator is standard decision-making support. The primary outcomes are decisional regret and decisional conflict. Secondary outcomes are improved knowledge and quality of life. Ethics approval obtained November 2014.

Conclusion:
This is one of the first randomized controlled trials assessing a decision support intervention in older people with advance chronic kidney disease. The results may provide guidance for clinicians in future approaches to assist this population in decision-making to ensure reduced decisional regret and decisional conflict
Keyword Chronic kidney disease
Conservative kidney management
Decision making
Dialysis
Non-dialysis management
Nurse
Randomized controlled trial
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

 
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