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Kidney Week

Abstract: TH-PO651

A Pilot Study of a Supportive Care Video Decision Aid on Knowledge for Elderly Patients with Advanced CKD

Session Information

  • Geriatric Nephrology
    November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Geriatric Nephrology

  • 1100 Geriatric Nephrology

Authors

  • Eneanya, Nwamaka D., University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Percy, Shananssa, Massachusetts General Hospital, Boston, Massachusetts, United States
  • Stallings, Taylor L., University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Steele, David J. R., Massachusetts General Hospital, Boston, Massachusetts, United States
  • Germain, Michael J., Baystate Medical Center, Springfield, Massachusetts, United States
  • Paasche-Orlow, Michael, Boston University, Boston, Massachusetts, United States
  • Volandes, Angelo, MGH, Waban, Massachusetts, United States
Background

The benefits of dialysis remain uncertain for elderly and frail patients with advanced chronic kidney disease (CKD). Although non-dialytic supportive kidney care (SKC) is an option for this patient population, there have been a lack of studies on patient-facing decision aids that specifically include this treatment approach. We performed a randomized controlled trial to test the efficacy of a video decision aid on knowledge of SKC among elderly patients with advanced CKD. We also assessed preferences for SKC and satisfaction and acceptability of the video.

Methods

Eligible patients were: age ≥ 65 years, English-speaking, had Stage 4 or 5 CKD, and were referred by their primary nephrologists at two academic centers in the US. Patients were randomized to receive education via a short verbal script or video. The video included images of patients undergoing hemodialysis, peritoneal dialysis or SKC. Patients received a knowledge questionnaire before and after receiving the verbal or video education.

Results

Among 100 enrolled participants, the mean age was 76 ± 6 years. Many were female (49%), White race (66%), and had completed high school education (85%). Knowledge of SKC increased in both arms after receiving education (p < 0.01); there was no difference in knowledge improvement between groups (Table 1). There was not a significant increase in those who preferred SKC after receiving either type of education (p = 0.20). The majority of patients who viewed the video felt comfortable watching it (96%), felt the content was helpful (96%) and would definitely recommend the video to others (72%).

Conclusion

Compared to an ideal verbal educational script, a video decision aid was not different in improving knowledge of SKC. Patients who received video education also reported high satisfaction and acceptability ratings. Future research will determine the effectiveness of a SKC video decision aid on patient preferences for treatment in real-world settings.

Table 1. Knowledge and preference for supportive care
 Total (N=100)Verbal script (N=50)Video (N = 50)P-value
Pre-education correct knowledge of supportive care (%)4138440.54
Pre-education preference for supportive care (%)2126160.22
Post-education knowledge of supportive care (%)6158640.54
Post-education preference for supportive care (%)2630220.36