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

Brown, Leanne, Gardner, Glenn, & 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), pp. 1191-1202.

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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.

Impact and interest:

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ID Code: 93039
Item Type: Journal Article
Refereed: Yes
Keywords: chronic kidney disease, conservative kidney management,, decision making dialysis, non-dialysis management, randomized controlled trial
DOI: 10.1111/jan.12921
ISSN: 0309-2402
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000) > Nursing not elsewhere classified (111099)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Nursing
Copyright Owner: Copyright 2016 John Wiley & Sons Ltd
Deposited On: 18 Feb 2016 03:42
Last Modified: 10 Jun 2016 03:06

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