Multi-disciplinary Participatory Design of a Process to Deliver a CKD Diagnosis in Primary Care (EPIK)
This study will use an adapted education worksheet to support patient-centered chronic kidney disease (CKD) communication, shared decision making, and patient engagement and will test its impact on intermediate patient modifiable characteristics in a primary care practice with patients who have pre-dialysis CKD.
The study team will enroll up to 100 patients with chronic kidney disease (CKD) from a primary care clinic to start. Patients will receive the intervention, which consists of the physicians using the education worksheet during appointments with patients, and patients and providers will complete surveys about its use and to measure impact on knowledge and other areas related to patient outcomes.
Once initial user testing is complete, the study team plans to submit an amendment to expand on this trial and incorporate comparison sites. This will be submitted and receive IRB approval prior to participant involvement.
The study hypothesis is that patients who receive the intervention will have greater knowledge about their CKD diagnosis, higher satisfaction with provider communication, and higher scores related to managing CKD to keep themselves healthy compared to control populations.
調査の概要
詳細な説明
Amendment on 12/2018: The enrollment numbers were updated to include the control group.
Clarification 9/2021: After initial feasibility was assessed, the initial site was used additionally to enroll for the "second arm", rather than a new site as originally intended. A second site was then used for the control population.
研究の種類
入学 (実際)
段階
- 適用できない
連絡先と場所
研究場所
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Michigan
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Canton、Michigan、アメリカ、48187
- Canton Health Center
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Northville、Michigan、アメリカ、48168
- Northville Health Center
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- 18 years old or older
- Have an estimated glomerular filtration rate (eGFR) of less than 60 ml/min/1.73 m2
- Able to read and understand English without an interpreter
- Diagnosed with chronic kidney disease on record
Exclusion Criteria:
- Patients with renal transplant or on dialysis
- Patients who have documented or provider known cognitive impairment or vision impairment that will prohibit meaningful interaction with education activation worksheet
- Patients who are not aware of their CKD diagnosis
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：防止
- 割り当て：非ランダム化
- 介入モデル：階乗代入
- マスキング：なし（オープンラベル）
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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実験的：Participatory design and intervention
Patients in this arm will receive the intervention of using an education worksheet during their appointment with their provider.
They will be asked to complete post intervention surveys (for feasibility and feedback prior to actual trial enrollment).
Providers and staff at this site have been involved in the design of the intervention process, to make it streamlined and efficient for application in practice.
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Patients who screen positive for CKD and give written informed consent to be a part of the study will have their chart flagged for the medical assistant and provider to give the education worksheet intervention.
The education worksheet has been developed to be used as an electronic tool within the Electronic Medical Record.
The provider will review it with the patient during the visit.
A paper copy will print out for the patient at the end of the visit.
他の名前：
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実験的：Intervention Only
This arm include new patients at the initial site that also received the intervention of using an education worksheet during their appointment and filled out post intervention surveys.
Some of these providers/staff were not involved in the initial design of the intervention.
|
Patients who screen positive for CKD and give written informed consent to be a part of the study will have their chart flagged for the medical assistant and provider to give the education worksheet intervention.
The education worksheet has been developed to be used as an electronic tool within the Electronic Medical Record.
The provider will review it with the patient during the visit.
A paper copy will print out for the patient at the end of the visit.
他の名前：
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介入なし：Usual Care
A second site included usual care, which did not include the intervention.
Participants were given post visit surveys similar to those in the two other study / intervention arms.
This site served as a usual care comparison.
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Level of objective understanding of CKD as measured by the Kidney Knowledge Survey (KiKS)
時間枠：Length of doctor's appointment, e.g., 1-2 hours
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This will measure objective kidney disease knowledge, based on a score of 0-100, where 0 means poor level of kidney knowledge, and 100 means good level of kidney knowledge.
The KiKS was developed by Dr. Wright.
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Length of doctor's appointment, e.g., 1-2 hours
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Level of perceived understanding of CKD as measured by the Perceived Kidney Knowledge Survey (PiKS)
時間枠：Length of doctor's appointment, e.g., 1-2 hours
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This will measure subjective kidney knowledge.
Score range is 1-4, where 1 is low level of perceived kidney knowledge, and 4 is high level of perceived kidney knowledge.
The PiKS was developed by Dr. Wright.
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Length of doctor's appointment, e.g., 1-2 hours
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Level of positive perception of patient-provider communication as measured by the Patient Communication Assessment Tool (CAT)
時間枠：Length of doctor's appointment, e.g., 1-2 hours
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This assesses the quality of physician to patient and physician's staff to patient communication.
Score range is 1-5, where 1 means negative perception of communication and 5 means positive perception of communication.
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Length of doctor's appointment, e.g., 1-2 hours
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Level of mental anxiety/stress related to condition as measured by the adapted NDBCSS scale
時間枠：Length of doctor's appointment, e.g., 1-2 hours
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The 19-item NDBCSS (Newly Diagnosed Breast Cancer Stress Scale) is adapted to form the 21-item scale in the patient survey to measure stress associated with CKD.
The score range is 1-4, where 1 means high level of stress associated with CKD and 4 means low level of stress associated with CKD.
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Length of doctor's appointment, e.g., 1-2 hours
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Level of energy/fatigue and emotional well-being as measured by the SF-36 mental health component
時間枠：4 weeks
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The SF-36 mental health component is a 9-item scale that measures energy/fatigue and emotional well-being in the past 4 weeks.Score range is 0-100, where 0 means poor emotional well-being and low energy and 100 means good emotional well-being and high energy.
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4 weeks
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その他の成果指標
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Level of positive assessment of care as measured by the Patient Assessment of Care for Chronic Conditions (PACIC) scale
時間枠：6 months
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This is a 11-item scale evaluating patient assessment of the quality of care that patients received in the past 6 months.
Score range is 1-5, where 1 means poor assessment of quality of care and 5 means good assessment of quality of care.
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6 months
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協力者と研究者
スポンサー
捜査官
- 主任研究者：Julie Wright-Nunes, MD, MPH、University of Michigan
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。
慢性腎臓病の臨床試験
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Adelphi Values LLCBlueprint Medicines Corporation完了肥満細胞性白血病 (MCL) | 攻撃的な全身性肥満細胞症 (ASM) | SM w Assoc Clonal Hema Non-mast Cell Lineage Disease (SM-AHNMD) | くすぶり全身性肥満細胞症 (SSM) | 無痛性全身性肥満細胞症 (ISM) ISM サブグループが完全に募集されましたアメリカ
Education worksheetの臨床試験
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University of SheffieldUniversity of Liverpool; University of Manchester; University of Melbourne積極的、募集していない