A Communication-Priming Intervention to Improve Shared Decision-Making Between Older Adults With Advanced CKD and Clinicians
A Communication-Priming Intervention to Improve Shared Decision-Making Between Older Adults With Advanced Chronic Kidney Disease and Clinicians: A Cluster-Randomized Controlled Trial
The University of Hong Kong
280 participants
Feb 4, 2025
INTERVENTIONAL
Conditions
Summary
To achieve the goal of reaching consensus about the preferred treatment option that best aligns with the goals and values of patients, the investigators developed a 'CKD Jumpstart- Tips" priming tool tailored for older adults with advanced CKD that is based on communication principles from VitalTalk and Elwyn's goal-based SDM model. The investigators hypothesize that compared with patients in the usual care group, patients in the 'CKD Jumpstart- Tips' intervention group will have: 1. increased level of shared decision-making (observer-based and patient-reported), 2. improved quality of communication, 3. increased patient involvement in decision-making, 4. lower decisional conflict, 5. lower decision regret, 6. decreased time to decision, 7. improved adherence to treatment choice, and 8. improved health-related quality-of-life.
Eligibility
Inclusion Criteria8
- Clinicians
- \- Nephrology specialists or higher physician trainees who provide specialty care to older adults with advanced chronic kidney disease
- Patients
- Diagnosis of advanced CKD Stage 4 or 5 (eGRF \<30 ml/min)
- Chinese- or English-speaking
- Identified as patient with whom their clinician plans to discuss advanced kidney disease treatment options in the upcoming clinic visit
- Able to provide written informed consent and complete questionnaires
- Can be contacted by phone
Exclusion Criteria1
- Patients will be excluded if they are eligible for kidney transplant, currently on dialysis, or lack decision-making capacity
Interventions
The intervention includes 2 components: 1. Patient Priming: Patients will receive the "Jumpstart CKD- Tips" communication priming tool within 1 week before and on the day of a target clinic visit, which includes surveys on (i) Understanding of illness and possible treatment options, (ii) Readiness for treatment discussion and information preferences, (iii) Health priorities, goals, and preferences (iv) Preferred roles in decision-making. The "Jumpstart CKD- Tips" patient priming sheet includes (a) A summary of their survey responses that can be shared with their healthcare team, and (b) Tips on communication with clinician during upcoming visit. 2. Clinician Priming: Within 1 week before and on the day of the target clinic visit, clinicians will receive a "Jumpstart CKD- Tips" clinician priming sheet which contains (a) An abstracted version of the patients' survey responses and (b) Communication tips tailored to the patient's responses based on Vitaltalk curricula materials.
Locations(1)
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NCT06799936