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A randomized controlled trial protocol testing a decision support intervention for older patients with advanced
Leanne Brown1,2, Glenn Gardner1, Ann Bonner1,2,3
1School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia.
Journal of Advanced Nursing
|February 17, 2016
Summary
This study evaluated a decision support intervention for older adults with advanced chronic kidney disease choosing between dialysis or non-dialysis management. The intervention aimed to reduce decisional regret and conflict, improving quality of life.
Area of Science:
- Gerontology
- Nephrology
- Health Decision Science
Background:
- The global population of individuals aged 65 and older is increasing.
- Older adults have a higher prevalence of chronic diseases, including chronic kidney disease (CKD).
- There is a growing number of older patients commencing dialysis, with emerging evidence suggesting limited benefit for some.
Purpose of the Study:
- To assess the effectiveness of a decision support intervention for older adults with advanced CKD.
- To evaluate the intervention's impact on decisional regret and decisional conflict.
- To explore improvements in knowledge and quality of life.
Main Methods:
- A pragmatic, single-blind, multisite randomized controlled trial was conducted.
- Participants were recruited from four Queensland public hospitals.
- The intervention involved multimodal decision support, including nurse-led counseling, compared to standard care.
Main Results:
- Primary outcomes measured were decisional regret and decisional conflict.
- Secondary outcomes included assessing improvements in patient knowledge and quality of life.
- Ethics approval was obtained in November 2014.
Conclusions:
- This study represents one of the first randomized controlled trials on decision support for older adults with advanced CKD.
- Findings may inform clinical practice for assisting this population in making informed treatment choices.
- The intervention aims to reduce decisional regret and conflict, enhancing patient-centered care.
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