Does an online decision aid help people with advanced chronic kidney disease choose between two treatment options?
In aim 3, we measured the effectiveness of the DA through a randomized controlled study of 140 predialysis CKD patients, including a pre-post assessment. RESULTS: The EPOCH-RRT study identified independence, flexibility, concerns about looks, and quality and quantity of life as some of the most freq...
| Main Authors: | , , , |
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| Corporate Author: | |
| Format: | eBook |
| Language: | English |
| Published: |
[Washington, D.C.]
Patient-Centered Outcomes Research Institute
2018, [2018]
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| Series: | Final research report
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| Online Access: | |
| Collection: | National Center for Biotechnology Information - Collection details see MPG.ReNa |
| Summary: | In aim 3, we measured the effectiveness of the DA through a randomized controlled study of 140 predialysis CKD patients, including a pre-post assessment. RESULTS: The EPOCH-RRT study identified independence, flexibility, concerns about looks, and quality and quantity of life as some of the most frequently reported patient priorities.55 The results from our surveys suggest that people who start PD are more often informed, engaged in the decision-making process, and satisfied with their dialysis modality; however, overall, a need for improving patient education, access to peers, and other support was identified. The DA developed in this study was subsequently shown to be effective in increasing knowledge and decreasing decisional conflict. CONCLUSIONS: EPOCH-RRT provided novel information that helps fill the knowledge gap on patients' perspectives on the choice of dialysis modality. A key innovation is the inclusion of patient representatives, caregivers (family members), and patient advocacy organizations as collaborators in all aspects of the study. Priorities, identified by patients and confirmed in a representative sample of US patients receiving HD and PD treatments, guided the development of the DA. The DA, now publicly available at www.choosingdialysis.org, will help empower patients in selecting the appropriate treatment modality that best fits their clinical as well as personal needs and lifestyle--thereby improving satisfaction with modality choice and potentially improving patient outcomes BACKGROUND: End-stage kidney disease poses a high health and societal burden on US patients and their families, with more than 100 000 patients starting dialysis every year. Although other treatment options are available, more than 90% of patients receive hemodialysis (HD) as their first renal replacement therapy modality. Little is known about factors that are important to chronic kidney disease (CKD) patients and their perspectives at the time they choose a dialysis modality. OBJECTIVES: The Empowering Patients on Choices for Renal Replacement Therapy (EPOCH-RRT) study aimed to identify patient priorities and gaps in shared decision-making with the support of the large cohort of nationally representative dialysis patients participating in the Dialysis Outcomes and Practice Patterns Study Program, to inform the development of a new web-based patient decision aid (DA) that would provide relevant information about the 2 most widely used dialysis options: in-center HD and peritoneal dialysis (PD). METHODS: Aim 1 was a mixed methods approach involving open-ended and closed-ended interview responses from 180 patients. This was followed by aim 2, implementation of a retrospective quantitative survey assessing the dialysis modality decision-making process and impact on the daily lives of 1963 HD and PD patients. We based the interview and survey design and subsequent development of the DA on feedback from a patient advisory panel. |
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| Physical Description: | 1 PDF file (70 pages) illustrations |