Abstract: FR-PO0451
Role of a Patient-Centered Brochure in Reducing Anxiety and Supporting Participation in the Incremental Hemodialysis in Veterans (INCHVETS) Pragmatic Randomized Controlled Trial
Session Information
- Dialysis: Measuring and Managing Symptoms and Syndromes
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Ismail, Adnan M., VA Long Beach Healthcare System, Long Beach, California, United States
- Tran, Diana, VA Long Beach Healthcare System, Long Beach, California, United States
- Simon, Lewis, VA Long Beach Healthcare System, Long Beach, California, United States
- Takahashi, Rina, VA Long Beach Healthcare System, Long Beach, California, United States
- Sy, John, University of California Irvine School of Medicine, Irvine, California, United States
- Siu, Man Kit Michael, VA Greater Los Angeles Healthcare System, Los Angeles, California, United States
- Tong, Lili, VA Long Beach Healthcare System, Long Beach, California, United States
- Chang, Yongen, University of California Irvine School of Medicine, Irvine, California, United States
- Crowley, Susan T., VA Connecticut Healthcare System, West Haven, Connecticut, United States
- Unruh, Mark L., New Mexico VA Health Care System, Albuquerque, New Mexico, United States
- Kovesdy, Csaba P., VA Memphis Healthcare System, Memphis, Tennessee, United States
- Rhee, Connie, VA Greater Los Angeles Healthcare System, Los Angeles, California, United States
- Kalantar-Zadeh, Kamyar, VA Long Beach Healthcare System, Long Beach, California, United States
Background
Veterans initiating dialysis often face difficult decisions under stressful conditions. Introducing the concept of random dialysis frequency assignment versus choice of incremental transition (starting with twice weekly) and standard (outright thrice-weekly) hemodialysis (HD), can add further confusion and anxiety for patients, care-partners, and providers, deterring trial enrollment. To support recruitment and shared decision-making (SDM) in INCHVETS study, a Veteran-centered brochure was made and piloted.
Methods
Using excerpts from the informed consent document, we developed a Veteran-centered brochure to explain the INCHVETS trial’s rationale, procedures, and expectations. It had accessible language, culturally appropriate framing, and structured visuals, including Figure 1 to illustrate randomization. Emphasizing voluntary participation, the brochure addressed Veterans and their care-partners’ concerns and was piloted to screen and recruit eligible participants.
Results
Research staff at one site presented the brochure to 66 Veterans with CKD5, including those who recently initiated HD. Following brochure-assisted screening, 36 patients enrolled, mean age was 73.1±8.9 years; all were male, 30% Black, 30% Hispanic, and 64% had diabetes mellitus. During discussions, four patients or care-partners expressed concern about being randomized to thrice-weekly hemodialysis if twice-weekly were sufficient; one patient declined participation for this reason. In another case, a care-partner raised concerns about adequacy of twice-weekly therapy.
Conclusion
The INCHVETS brochure facilitates informed consent and reduces confusion around trial participation, particularly in relation to randomization versus patient-directed choice of dialysis frequency. By presenting complex study concepts in an accessible, Veteran-centered format, the brochure supported SDM and enrollment among a diverse incident dialysis population.
Funding
- Veterans Affairs Support