Improving Shared Decision-Making Between Older Adults with Advanced Chronic Kidney Disease and Clinicians Using a Communication-Priming Tool

What this Trial Is About

Researchers are evaluating a communication-priming intervention called CKD Jumpstart- Tips aimed at improving shared decision-making between older adults with advanced chronic kidney disease CKD and their clinicians. This cluster-randomized controlled trial focuses on patients with CKD Stage 4 or 5, seeking to enhance communication quality, patient involvement, decisional conflict, decision regret, timing and adherence to treatment choices, and health-related quality of life. The study compares two groups one receiving the CKD Jumpstart- Tips intervention and the other receiving usual care. Patients in the intervention group complete the priming tool before a target clinic visit and receive a summary sheet with communication tips and survey responses to share with their healthcare team. Clinicians also receive a priming sheet with tailored communication guidance based on patient responses. Additional educational materials on kidney failure treatment options are available as part of routine care. Participants will be assessed immediately after the target visit and followed for up to six months. Evaluations include observer-rated and patient-reported shared decision-making, quality of communication, consultation length, patient involvement, decisional conflict and regret, timing and adherence to treatment, and health-related quality of life. The study aims to measure the impact of the communication intervention on these outcomes while monitoring patient experience and treatment decisions over time.

A Communication-Priming Intervention to Improve Shared Decision-Making Between Older Adults With Advanced CKD and Clinicians