Facilitating Anemia Treatment Risk Communication for Patients With Kidney Disease: Decision Aid Trial

Anemia is a common complication of chronic kidney disease (CKD). In anemia of chronic kidney
disease, patients suffer from low hemoglobin levels, which contribute to feelings of malaise
and fatigue. The current accepted practice is often to administer erythropoietin-stimulating
agents (ESAs), which act like the body's natural hormones to stimulate the production of red
blood cells from bone marrow. Although ESAs are widely used in CKD, recent evidence suggests
that they are not as safe as previously thought. In this study, we seek to test a decision
aid to be used when a patient visits his or her nephrologist at Vanderbilt. The objective of
the decision aid is to reduce patient confusion, improve their satisfaction with their care,
improve their knowledge of kidney disease, and ultimately bring more clarity to patients
about a controversial but ubiquitous drug.

The decision aid will be about 1 page long and will include questions and information that
might help the patient be more active and informed regarding the choice of a course of ESA
therapy. We will ask patients to answer questions before and after their clinic visits
regarding their satisfaction and confidence in their treatment and their knowledge of kidney
disease; we will ask some of the same questions 3 months after the clinic visit. We will
compare patients who are counseled using the decision aid to patients who are not. We
anticipate total experiment running time to be approximately 5 months to recruit and follow
up on all patients.