Trial to Improve Decision-Making Support for Adults with Stage 4 Chronic Kidney Disease and Their Caregivers Using a Telehealth Intervention

What this Trial Is About

This research aims to develop and refine decision partnering skills between patients with stage 4 chronic kidney disease CKD and their caregivers. It focuses on improving how these dyads make health-related decisions throughout the illness, addressing gaps in current interventions that often exclude caregivers and overlook broader decision-making beyond specific medical treatments. The study uses the Multiphase Optimization Strategy MOST to test different training components efficiently. Participants are randomized into one of eight groups receiving various combinations of caregiver coaching sessions, caregiver communication training, and patient psychoeducation. The intervention is delivered via telehealth and includes weekly sessions and monthly follow-up calls to support decision-making partnerships. Components tested include differing numbers of coaching sessions and the presence or absence of communication and psychoeducation training. Participants and their caregivers engage in assessments at baseline, 12 weeks, and 24 weeks to evaluate the feasibility, acceptability, and preliminary impact of the intervention components. Measures include decision conflict, social support effectiveness, distress, quality of life, and dyadic coping. The study lasts 24 weeks, with close monitoring of intervention completion and data collection processes to inform future trials.

A Stakeholder-enhanced Intervention to Improve the Decisional Partnership of Chronic Kidney Disease Dyads (IMPART)