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Randomized Controlled Trial
. 2018 Aug;18(8):1954-1965.
doi: 10.1111/ajt.14693. Epub 2018 Mar 26.

Effect of the iChoose Kidney decision aid in improving knowledge about treatment options among transplant candidates: A randomized controlled trial

Rachel E Patzer  1 , Laura McPherson  1 , Mohua Basu  1 , Sumit Mohan  2 , Michael Wolf  3 , Mariana Chiles  2 , Allison Russell  3 , Jennifer C Gander  1 , John J Friedewald  3 , Daniela Ladner  3 , Christian P Larsen  1 , Thomas Pearson  1 , Stephen Pastan  4
Affiliations
Randomized Controlled Trial

Effect of the iChoose Kidney decision aid in improving knowledge about treatment options among transplant candidates: A randomized controlled trial

Rachel E Patzer et al. Am J Transplant. 2018 Aug.

Abstract

We previously developed a mobile- and web-based decision aid (iChoose Kidney) that displays individualized risk estimates of survival and mortality, for the treatment modalities of dialysis versus kidney transplantation. We examined the effect of iChoose Kidney on change in transplant knowledge and access to transplant in a randomized controlled trial among patients presenting for evaluation in three transplant centers. A total of 470 patients were randomized to standard transplantation education (control) or standard education plus iChoose Kidney (intervention). Change in transplant knowledge (primary outcome) among intervention versus control patients was assessed using nine items in pre- and postevaluation surveys. Access to transplant (secondary outcome) was defined as a composite of waitlisting, living donor inquiries, or transplantation. Among 443 patients (n = 226 intervention; n = 216 control), the mean knowledge scores were 5.1 ± 2.1 pre- and 5.8 ± 1.9 postevaluation. Change in knowledge was greater among intervention (1.1 ± 2.0) versus control (0.4 ± 1.8) patients (P < .0001). Access to transplantation was similar among intervention (n = 168; 74.3%) versus control patients (n = 153; 70.5%; P = .37). The iChoose Kidney decision aid improved patient knowledge at evaluation, but did not impact transplant access. Future studies should examine whether combining iChoose Kidney with other interventions can increase transplantation. (Clinicaltrials.gov NCT02235571).

Keywords: clinical research/practice; dialysis; education; health services and outcomes research; kidney disease; kidney transplantation/nephrology; patient education; patient survival.

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Conflict of interest statement

DISCLOSURE

The authors of this manuscript have no conflicts of interest to disclose as described by the American Journal of Transplantation.

Figures

FIGURE 1
FIGURE 1
Screenshots of the iChoose Kidney Decision Aid (iPad version) outlining the varying message frames used to enter patient’s clinical information (gender, age, race, ethnicity, time on dialysis, various comorbidities) into the risk prediction calculator for individualized 1- and 3-year mortality (not shown) and survival estimates of dialysis versus kidney transplant and deceased versus living donor transplant
FIGURE 2
FIGURE 2
Study schema of the iChoose Kidney randomized controlled trial depicting the study process and points of data collection for both control and intervention patients, and providers (transplant nephrologists or surgeons), 2014–2015
FIGURE 3
FIGURE 3
Flow diagram of recruitment into the iChoose Kidney randomized controlled trial among ESRD patients evaluated for a kidney transplant at three US transplant centers, 2014–2015
See this image and copyright information in PMC

References

    1. USRDS. U S Renal Data System. USRDS 2017 Annual Data Report : Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2017.
    1. Tonelli M, Wiebe N, Knoll G, et al. Systematic review: kidney transplantation compared with dialysis in clinically relevant outcomes. Am J Transplant 2011;11(10):2093–2109. - PubMed
    1. Danovitch GM. Options for Patients with Kidney Failure. In: Danovitch GM, ed. Handbook of Kidney Transplantation, 2nd edn. Philadelphia, PA: Lippincott Williams & Wilkins; 2005:1–22.
    1. Wolfe RA, Ashby VB, Milford EL, et al. Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. N Eng J Med 1999;341(23):1725–1730. - PubMed
    1. Sheu J, Ephraim PL, Powe NR, et al. African American and non-African American patients’ and families’ decision making about renal replacement therapies. Qual Health Res 2012;22(7):997–1006. - PMC - PubMed

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