Multi-disciplinary Participatory Design of a Process to Deliver a CKD Diagnosis in Primary Care (EPIK)
14. september 2021 oppdatert av: Julie Wright-Nunes, University of Michigan
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.
Studieoversikt
Status
Fullført
Forhold
Intervensjon / Behandling
Detaljert beskrivelse
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.
Studietype
Intervensjonell
Registrering (Faktiske)
78
Fase
- Ikke aktuelt
Kontakter og plasseringer
Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.
Studiesteder
-
-
Michigan
-
Canton, Michigan, Forente stater, 48187
- Canton Health Center
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Northville, Michigan, Forente stater, 48168
- Northville Health Center
-
-
Deltakelseskriterier
Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
18 år og eldre (Voksen, Eldre voksen)
Tar imot friske frivillige
Nei
Kjønn som er kvalifisert for studier
Alle
Beskrivelse
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
Studieplan
Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Forebygging
- Tildeling: Ikke-randomisert
- Intervensjonsmodell: Faktoriell oppgave
- Masking: Ingen (Open Label)
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
|
Eksperimentell: 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.
|
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.
Andre navn:
|
|
Eksperimentell: 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.
Andre navn:
|
|
Ingen inngripen: 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.
|
Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Level of objective understanding of CKD as measured by the Kidney Knowledge Survey (KiKS)
Tidsramme: Length of doctor's appointment, e.g., 1-2 hours
|
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.
|
Length of doctor's appointment, e.g., 1-2 hours
|
|
Level of perceived understanding of CKD as measured by the Perceived Kidney Knowledge Survey (PiKS)
Tidsramme: Length of doctor's appointment, e.g., 1-2 hours
|
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.
|
Length of doctor's appointment, e.g., 1-2 hours
|
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Level of positive perception of patient-provider communication as measured by the Patient Communication Assessment Tool (CAT)
Tidsramme: Length of doctor's appointment, e.g., 1-2 hours
|
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.
|
Length of doctor's appointment, e.g., 1-2 hours
|
|
Level of mental anxiety/stress related to condition as measured by the adapted NDBCSS scale
Tidsramme: Length of doctor's appointment, e.g., 1-2 hours
|
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.
|
Length of doctor's appointment, e.g., 1-2 hours
|
|
Level of energy/fatigue and emotional well-being as measured by the SF-36 mental health component
Tidsramme: 4 weeks
|
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.
|
4 weeks
|
Andre resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Level of positive assessment of care as measured by the Patient Assessment of Care for Chronic Conditions (PACIC) scale
Tidsramme: 6 months
|
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.
|
6 months
|
Samarbeidspartnere og etterforskere
Det er her du vil finne personer og organisasjoner som er involvert i denne studien.
Sponsor
Samarbeidspartnere
Etterforskere
- Hovedetterforsker: Julie Wright-Nunes, MD, MPH, University of Michigan
Studierekorddatoer
Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.
Studer hoveddatoer
Studiestart (Faktiske)
5. juni 2017
Primær fullføring (Faktiske)
11. september 2020
Studiet fullført (Faktiske)
11. september 2020
Datoer for studieregistrering
Først innsendt
20. februar 2017
Først innsendt som oppfylte QC-kriteriene
13. mars 2017
Først lagt ut (Faktiske)
20. mars 2017
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
21. september 2021
Siste oppdatering sendt inn som oppfylte QC-kriteriene
14. september 2021
Sist bekreftet
1. september 2021
Mer informasjon
Begreper knyttet til denne studien
Ytterligere relevante MeSH-vilkår
Andre studie-ID-numre
- HUM00118819
- 4K23DK097183-04 (U.S. NIH-stipend/kontrakt)
Plan for individuelle deltakerdata (IPD)
Planlegger du å dele individuelle deltakerdata (IPD)?
NEI
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Nei
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