Abstract: SA-PO1186
How Comprehensive Kidney Replacement Therapy (KRT)-Directed Patient Education (CoPE) Affects Reasoning in KRT Decision-Making
Session Information
- CKD: Biomarkers and Emerging Tools for Diagnosis and Monitoring
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Campbell-Montalvo, Rebecca, US Department of Veterans Affairs Veterans Health Administration, Washington, District of Columbia, United States
- Ftouni, Darin, US Department of Veterans Affairs Veterans Health Administration, Washington, District of Columbia, United States
- Shell, Popy, US Department of Veterans Affairs Veterans Health Administration, Washington, District of Columbia, United States
- Subhash, Shobha, US Department of Veterans Affairs Veterans Health Administration, Washington, District of Columbia, United States
- Shukla, Ashutosh M., US Department of Veterans Affairs Veterans Health Administration, Washington, District of Columbia, United States
Background
Pre-dialysis care is crucial in whether a patient can obtain dialysis modality of their choice when the time comes. Key in this care is the provision of patient education about available treatment types, including details about how they might be carried out relative to one’s personal context. To inform optimal patient education design, this research identifies treatment decision reasons provided by patients receiving CoPE vs. control.
Methods
Interviews eliciting the main reasons for treatment choice (i.e., home dialysis, in-center dialysis, conservative care, undecided) were conducted with 42 Veterans with chronic kidney disease on average 163 days post-intervention. Twenty-six received CoPE (videos and individual counseling) while 16 received control (enhanced usual care [EUC]—a pamphlet mailed home containing links to free online resources).
Results
There were 113 total reasons for treatment choice provided, which were sorted into 16 emergent categories. Participants each identified 2-3 reasons on average. Percent analysis compared reason frequency across condition (i.e., CoPE, EUC), with some reasons more common in one condition (i.e., ≥5 percentage points higher than representative). CoPE prompted focus on treatment details (context of sleep; can be done while sleeping), actual execution concerns (context of social support; lacking confidence in ability to engage in treatment), and how treatment would impact quality of life (ability to maintain lifestyle; does not have to travel to center*). EUC rationale centered around scheduling (occasional travel*, flexibility, vacationing*) though being able to receive treatment at home was important—and notably relates to scheduling. Asterisked reasons most pronounced (i.e., ≥10 percentage points higher than representative).
Conclusion
In EUC, reasons clustered around scheduling, while there was a wider spread of reasons across domains in CoPE. This suggests 1) that the CoPE recipients had more familiarity with treatment details, and consequently 2) that CoPE recipients considered more possible variables and impacts of their choice in the larger context of their personal life situation. In sum, this work both validates that CoPE supports a more informed decision, and offers insight into educational content design.
Funding
- Other U.S. Government Support