Health Outcomes Patient Education
| Status: | Completed |
|---|---|
| Conditions: | Renal Impairment / Chronic Kidney Disease, Renal Impairment / Chronic Kidney Disease |
| Therapuetic Areas: | Nephrology / Urology |
| Healthy: | No |
| Age Range: | Any - 90 |
| Updated: | 10/29/2017 |
| Start Date: | November 2016 |
| End Date: | October 2017 |
This study is designed to evaluate the feasibility of using digital-enabled education in
clinical care in order to improve patient outcomes related to end-stage renal disease (ESRD).
If effective, educational interventions could be used to improve the long-term survival of
patients with chronic kidney disease (CKD) and to make clinical care for these patients more
cost effective.
clinical care in order to improve patient outcomes related to end-stage renal disease (ESRD).
If effective, educational interventions could be used to improve the long-term survival of
patients with chronic kidney disease (CKD) and to make clinical care for these patients more
cost effective.
Studies have shown that educational interventions in patients nearing end-stage renal disease
(ESRD) can delay the need for dialysis and increase the likelihood of the patient choosing
in-home vs. in-center dialysis. Given the higher cost of in-center hemodialysis compared to
in-home strategies, such as peritoneal dialysis, efforts at increasing use of in-home
dialysis modalities are likely to be cost-effective. Moreover, while few studies of
educational interventions have long-term follow-up, one study suggests that patients exposed
to educational interventions have improved long-term survival once on dialysis.
The long-term goal is to improve clinical and patient-centered outcomes in patients
transitioning from Chronic Kidney Disease Stage (CKD) IV and V to dialysis-requiring ESRD.
The short-term goal of this pilot project is to evaluate the feasibility of delivering
digital-enabled ESRD education to patients with CKD stage IV and V (eGFR<30ml/min/1.73m2, not
yet on dialysis) in clinical care. The investigators will provide this education in the form
of in-person nurse advice, online digital content including videos, and online messaging with
a nurse, moderated patient group and peer mentor. The main objective of the educational
program will be to 1) Increase awareness of options, 2) Prioritize options based on patient
lifestyle and values, 3) Build confidence in modality decision.
The investigators will develop individualized, digitalized educational content (which
includes videos, text and illustration) for patients with CKD that will increase awareness of
ESRD care options including in-home hemodialysis, peritoneal dialysis and choosing not to
have dialysis. Patients will enroll in a month-long program during which they have access to
the educational app, including lifestyle and modality educational content and online
messaging where they can access a nurse for 1 on 1 discussion, a patient mentor for 1 on 1
discussion, and a patient group for group mentorship exercises. The investigators will pilot
these materials in patients at high risk of progression to dialysis and evaluate the primary
outcomes of whether they were able to complete the program and make a modality choice.
Secondary outcomes will include assessments to determine the intervention's impact on patient
dialysis modality awareness and likelihood of choosing a home-dialysis modality. At the end
of the study, the investigators will provide an insights report to the study participants'
doctors and survey the doctors to ascertain their perspectives on the usefulness of the
educational program for their patients' care.
(ESRD) can delay the need for dialysis and increase the likelihood of the patient choosing
in-home vs. in-center dialysis. Given the higher cost of in-center hemodialysis compared to
in-home strategies, such as peritoneal dialysis, efforts at increasing use of in-home
dialysis modalities are likely to be cost-effective. Moreover, while few studies of
educational interventions have long-term follow-up, one study suggests that patients exposed
to educational interventions have improved long-term survival once on dialysis.
The long-term goal is to improve clinical and patient-centered outcomes in patients
transitioning from Chronic Kidney Disease Stage (CKD) IV and V to dialysis-requiring ESRD.
The short-term goal of this pilot project is to evaluate the feasibility of delivering
digital-enabled ESRD education to patients with CKD stage IV and V (eGFR<30ml/min/1.73m2, not
yet on dialysis) in clinical care. The investigators will provide this education in the form
of in-person nurse advice, online digital content including videos, and online messaging with
a nurse, moderated patient group and peer mentor. The main objective of the educational
program will be to 1) Increase awareness of options, 2) Prioritize options based on patient
lifestyle and values, 3) Build confidence in modality decision.
The investigators will develop individualized, digitalized educational content (which
includes videos, text and illustration) for patients with CKD that will increase awareness of
ESRD care options including in-home hemodialysis, peritoneal dialysis and choosing not to
have dialysis. Patients will enroll in a month-long program during which they have access to
the educational app, including lifestyle and modality educational content and online
messaging where they can access a nurse for 1 on 1 discussion, a patient mentor for 1 on 1
discussion, and a patient group for group mentorship exercises. The investigators will pilot
these materials in patients at high risk of progression to dialysis and evaluate the primary
outcomes of whether they were able to complete the program and make a modality choice.
Secondary outcomes will include assessments to determine the intervention's impact on patient
dialysis modality awareness and likelihood of choosing a home-dialysis modality. At the end
of the study, the investigators will provide an insights report to the study participants'
doctors and survey the doctors to ascertain their perspectives on the usefulness of the
educational program for their patients' care.
Inclusion Criteria:
- eGFR < 30ml/min/1.73m²
- Regular attendance at the nephrology clinic; at least two visits within the last 18
months
- Clinic notes indicate patient has had discussion with a nephrologist regarding needing
dialysis in the future
Exclusion Criteria:
- Homelessness
- Non-English speaking
- No phone or no internet access on one of the following: smart phone, tablet, or
computer
- No e-mail access
- Age ≥ 90 years
- Hospitalized more than twice during the last 6 months
- Dementia
- Severe cognitive impairment
- Blindness
- Deafness
We found this trial at
1
site
San Francisco, California
Principal Investigator: Ruth Dubin, MD
Phone: 415-221-4810
Click here to add this to my saved trials
