- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03454022
Decision-Aid for Renal Therapy Pilot Trial
Decision-Aid for Renal Therapy Pilot Trial (DART Pilot Trial)
Study Overview
Status
Intervention / Treatment
Detailed Description
Successful end-of-life communication between patients, caregivers, and physicians is associated with superior psychosocial outcomes, less intensive treatment, greater satisfaction, and higher likelihood of death at home. The Decision-Aid for Renal Therapy (DART) is an interactive web-based decision-aid that can empower patients and caregivers to select the treatment choice for chronic kidney disease that best suits them. DART was developed using a rigorous, validated, patient-engaged process and helps clarify decision-points and tradeoffs by providing individualized information about outcomes that matter most to patients. DART is designed to promote shared decision-making between patients, caregivers, and physicians and align preferences with treatment received.
Although proven effective and in current use in the general population, DART's effectiveness in an older population is unclear. The purpose of this project is to conduct a pilot study of DART's feasibility and effectiveness to improve end-of-life planning and shared decision-making among older end-stage renal disease patients.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
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Massachusetts
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Boston, Massachusetts, United States, 02111
- Tufts Medical Center
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Brighton, Massachusetts, United States, 02135
- St. Elizabeth's Medical Center
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Chronic kidney disease stages 4 or 5, not currently on dialysis
- Age >=70
- English-speaking
- Willingness to be randomized to DART
- Able to sign informed consent
- 5-year kidney failure risk probability > 15% using [www.kidneyfailurerisk.com]
- Glomerular filtration rate (GFR) < 30
Exclusion Criteria:
- Non-English speaking
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Usual care
Participants receive an educational pamphlet from the National Kidney Foundation, "Choosing a Treatment for Kidney Failure."
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This is an educational pamphlet published by the National Kidney Foundation.
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Experimental: DART
Participants receive an educational pamphlet from the National Kidney Foundation, "Choosing a Treatment for Kidney Failure."
They also receive a link to access the web-based decision-aid program, Decision-Aid for Renal Therapy (DART).
Participants may access this program using a computer at home throughout the duration of the trial.
Those who do not have a computer with web access at home are assisted in watching the program in the clinic.
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This is an educational pamphlet published by the National Kidney Foundation.
A one-hour long web-based decision-aid program that explains treatment options for end-stage renal disease, including the benefits and risks of each treatment option.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Completion of advance directives at 3 months.
Time Frame: Assessed at 3 months
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Participants will be asked if they have completed an advance directive.
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Assessed at 3 months
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Change in baseline Decisional Conflict Scale score at 3 months.
Time Frame: Assessed in patients at 3 months.
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Measures personal perceptions of: a) uncertainty in choosing options; b) modifiable factors contributing to uncertainty such as feeling uninformed, unclear about personal values and unsupported in decision making; and c) effective decision making such as feeling the choice is informed, values-based, likely to be implemented and expressing satisfaction with the choice.
Scores range from 0 (no decisional conflict) to 100 (extremely high decisional conflict).
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Assessed in patients at 3 months.
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Congruence in patient-caregiver goals of care
Time Frame: Assessed in patients and caregivers at 6 months.
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Patients and caregivers are each administered a questionnaire to determine what the patient's goals of care are at the end of life.
The congruence (agreement) between the stated preferences of the patient and caregiver will be assessed at 6 months.
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Assessed in patients and caregivers at 6 months.
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Change in baseline overall patient satisfaction score from the Canadian Health Care Evaluation Project (CANHELP) questionnaire at 3 months.
Time Frame: Assessed in patients at 3 months.
|
A survey instrument that evaluates satisfaction with care for older patients with life threatening illnesses, and their family members.
The overall CANHELP Lite satisfaction score is calculated as the unweighted average of all answered questions.
The score is then rescaled to range between 0 (worst possible value) to 100 (best possible value).
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Assessed in patients at 3 months.
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Change in baseline overall caregiver satisfaction score from the Canadian Health Care Evaluation Project (CANHELP) questionnaire at 3 months.
Time Frame: Assessed in caregivers at 3 months.
|
A survey instrument that evaluates satisfaction with care for older patients with life threatening illnesses, and their family members.
The overall CANHELP Lite satisfaction score is calculated as the unweighted average of all answered questions.
All scores are rescaled to range between 0 (worst possible value) to 100 (best possible value).
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Assessed in caregivers at 3 months.
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Keren Ladin, PhD, Tufts University
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 12345 (Danish Center for Healthcare Improvements)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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