Pilot Testing of a Communication Intervention to Promote Shared Dialysis Decision Making in Older Patients with Chronic Kidney Disease (DIAL-SDM Trial)
对促进老年慢性肾病患者共同透析决策的沟通干预进行试点测试(DIAL-SDM 试验)
基本信息
- 批准号:10609444
- 负责人:
- 金额:$ 18.98万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2020
- 资助国家:美国
- 起止时间:2020-07-01 至 2024-09-30
- 项目状态:已结题
- 来源:
- 关键词:AddressAdultAffectAttentionAwardCancer PatientCaregiversChronic Kidney FailureClinicalCodeCollaborationsCommunicationControl GroupsDataDecision MakingDevelopmentDialysis procedureEducationEffectiveness of InterventionsElderlyEmotionalEnd stage renal failureEnrollmentFaceFamily CaregiverFeasibility StudiesFeedbackFellowshipFollow-Up StudiesFundingFutureGlomerular Filtration RateGoalsGrantGuidelinesHealthHomeHospitalizationIndividualInterventionKidneyLeadLeadershipLifeMeasuresMentorsMethodsModificationNephrologyOffice VisitsOncologistOutcomeOutcome StudyPalliative CarePatient ParticipationPatient PreferencesPatientsPhysiciansPopulationPragmatic clinical trialPrognosisProtocols documentationQuality of lifeQuestionnairesRandomizedRecommendationRegretsReportingResearchResearch PersonnelStandardizationTechnologyTestingTimeTrainingWritingcareercareer developmentcommunication behaviorcomorbiditycomparison controleffectiveness studyexpectationgroup interventionhuman old age (65+)improvedinnovationinstructorintervention effectolder patientpatient engagementpilot testpragmatic trialpreferenceprognosticprospectiverandomized, clinical trialsshared decision makingskillsskills trainingtreatment as usualtreatment choice
项目摘要
Brief Summary
Older patients ≥65 years with chronic kidney disease (CKD) face challenges in decision making around dialysis
initiation. These patients report little effort by physicians to elicit treatment preferences, discuss prognoses or
explain the burdens/benefits of dialysis options including conservative management. Older patients with CKD
often prefer maintaining the quality of life over prolonging life, and many regret their decision to start dialysis:
nearly one quarter withdraw from dialysis each year. Shared dialysis decision-making requires active
engagement between nephrologists and patients to align patient, caregiver and physician communication around
common goals. The proposed study is a pilot randomized cluster pragmatic trial of a shared dialysis decision-
making (DIAL-SDM) intervention for nephrologists (n=20) and their patients ≥65 years old (n=60) with an
estimated glomerular filtration rate (eGFR) of ≤ 20 ml/min/ /1.73 m2. Nephrologists in the Intervention Group will
receive 3 remote online communication training sessions, delivered by a standardized patient instructor (SPI)
via Zoom technology who will enact clinical scenarios and offer feedback. In parallel, patients (and caregivers, if
available) will receive 2 coaching sessions provided by a health coach, who will explore each patient's relevant
contextual information (values, preferences, and goals), and help them identify and practice important questions
for their nephrologist. Nephrologists in the Control Group will provide their patients with usual care. The study
outcomes will be assessed during two nephrology office visits and at 6 months.
Specifically, we aim to:
Aim 1 (primary): Assess the feasibility, acceptability, and fidelity of the DIAL-SDM intervention.
Aim 2 (secondary): Test the preliminary effectiveness of the intervention on (a) active patient participation in
dialysis decision-making, as measured by the Active Patient Participation Coding scores from audio-recordings
of office visits; (b) shared dialysis decision-making, as measured by OPTION scale scores from audio-recordings
of the office visits, and patient-reported Shared Decision-Making Questionnaire; (c) patients' initial choice of
dialysis options (home vs. in-center dialysis vs. conservative management).
小结
65岁以上的慢性肾病患者≥面临着围绕透析的决策挑战
入会仪式。这些患者报告说,医生几乎没有努力去引起治疗偏好,讨论预后或
解释透析选项的负担/好处,包括保守治疗。老年慢性肾脏病患者
与延长生命相比,他们往往更喜欢保持生活质量,许多人后悔自己开始透析的决定:
每年有近四分之一的患者停止透析。共享透析决策需要积极主动
肾脏科医生和患者之间的接触,以使患者、护理者和医生之间的沟通保持一致
共同的目标。拟议的研究是一项共享透析决定的试点随机群实用试验-
肾病专科医生(n=20)及其65岁≥患者(n=60)的Dial-SDM干预
估计肾小球滤过率(≤)为20ml/min//1.73m2。干预组的肾科医生将
接受3个远程在线沟通培训课程,由标准化患者导师(SPI)授课
通过Zoom技术,谁将制定临床方案并提供反馈。同时,患者(和照顾者,如果
将接受由健康教练提供的2次辅导课程,健康教练将探索每位患者的相关
背景信息(价值观、偏好和目标),并帮助他们识别和实践重要问题
给他们的肾病科医生。对照组的肾科医生将为他们的患者提供常规护理。这项研究
结果将在两次肾内科办公室访问期间和6个月时进行评估。
具体来说,我们的目标是:
目标1(主要):评估DIAL-SDM干预的可行性、可接受性和保真度。
目标2(次级):测试干预的初步效果:(A)患者积极参与
透析决策,通过来自录音的活跃的患者参与编码分数来衡量
办公室访问;(B)共享透析决策,以录音中的选项量表分数衡量
和患者报告的共享决策问卷;(C)患者最初选择
透析选项(家庭透析与中心内透析与保守治疗)。
项目成果
期刊论文数量(0)
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会议论文数量(0)
专利数量(0)
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{{ truncateString('Fahad Saeed', 18)}}的其他基金
Pilot Testing of a Communication Intervention to Promote Shared Dialysis Decision Making in Older Patients with Chronic Kidney Disease (DIAL-SDM Trial)
对促进老年慢性肾病患者共同透析决策的沟通干预进行试点测试(DIAL-SDM 试验)
- 批准号:
10159888 - 财政年份:2020
- 资助金额:
$ 18.98万 - 项目类别:
Pilot Testing of a Communication Intervention to Promote Shared Dialysis Decision Making in Older Patients with Chronic Kidney Disease (DIAL-SDM Trial)
对促进老年慢性肾病患者共同透析决策的沟通干预进行试点测试(DIAL-SDM 试验)
- 批准号:
9976804 - 财政年份:2020
- 资助金额:
$ 18.98万 - 项目类别:
Multimodal Machine-Learning and High Performance Computing Strategies for Big MS Proteomics Data
MS 蛋白质组大数据的多模态机器学习和高性能计算策略
- 批准号:
10372290 - 财政年份:2020
- 资助金额:
$ 18.98万 - 项目类别:
Pilot Testing of a Communication Intervention to Promote Shared Dialysis Decision Making in Older Patients with Chronic Kidney Disease (DIAL-SDM Trial)
对促进老年慢性肾病患者共同透析决策的沟通干预进行试点测试(DIAL-SDM 试验)
- 批准号:
10379466 - 财政年份:2020
- 资助金额:
$ 18.98万 - 项目类别:
Multimodal Machine-Learning and High Performance Computing Strategies for Big MS Proteomics Data
MS 蛋白质组大数据的多模态机器学习和高性能计算策略
- 批准号:
10163880 - 财政年份:2020
- 资助金额:
$ 18.98万 - 项目类别:
Multimodal Machine-Learning and High Performance Computing Strategies for Big MS Proteomics Data
MS 蛋白质组大数据的多模态机器学习和高性能计算策略
- 批准号:
10413045 - 财政年份:2020
- 资助金额:
$ 18.98万 - 项目类别:
Compute-Cluster for Deep-Learning Models for Mass Spectrometry based Proteomics data
基于质谱的蛋白质组数据深度学习模型的计算集群
- 批准号:
10389445 - 财政年份:2020
- 资助金额:
$ 18.98万 - 项目类别:
Pilot Testing of a Communication Intervention to Promote Shared Dialysis Decision Making in Older Patients with Chronic Kidney Disease (DIAL-SDM Trial)
对促进老年慢性肾病患者共同透析决策的沟通干预进行试点测试(DIAL-SDM 试验)
- 批准号:
10887101 - 财政年份:2020
- 资助金额:
$ 18.98万 - 项目类别:
Multimodal Machine-Learning and High Performance Computing Strategies for Big MS Proteomics Data
MS 蛋白质组大数据的多模态机器学习和高性能计算策略
- 批准号:
9973317 - 财政年份:2020
- 资助金额:
$ 18.98万 - 项目类别:
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