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A Randomized Controlled Trial of a Mobile Clinical Decision Aid to Improve Access to Kidney Transplantation: iChoose Kidney

INTRODUCTION: Kidney transplantation is the preferred treatment for patients with end-stage renal disease, as it substantially increases a patient’s survival and is cost-saving compared to a lifetime of dialysis. However, transplantation is not universally chosen by patients with renal failure, and...

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Autores principales: Patzer, Rachel E., Basu, Mohua, Mohan, Sumit, Smith, Kayla D., Wolf, Michael S., Ladner, Daniela P., Friedewald, John J., Chiles, Mariana C., Russell, Allison L., McPherson, Laura J., Gander, Jennifer C., Pastan, Stephen O.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5012277/
https://www.ncbi.nlm.nih.gov/pubmed/27610423
http://dx.doi.org/10.1016/j.ekir.2016.04.001
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author Patzer, Rachel E.
Basu, Mohua
Mohan, Sumit
Smith, Kayla D.
Wolf, Michael S.
Ladner, Daniela P.
Friedewald, John J.
Chiles, Mariana C.
Russell, Allison L.
McPherson, Laura J.
Gander, Jennifer C.
Pastan, Stephen O.
author_facet Patzer, Rachel E.
Basu, Mohua
Mohan, Sumit
Smith, Kayla D.
Wolf, Michael S.
Ladner, Daniela P.
Friedewald, John J.
Chiles, Mariana C.
Russell, Allison L.
McPherson, Laura J.
Gander, Jennifer C.
Pastan, Stephen O.
author_sort Patzer, Rachel E.
collection PubMed
description INTRODUCTION: Kidney transplantation is the preferred treatment for patients with end-stage renal disease, as it substantially increases a patient’s survival and is cost-saving compared to a lifetime of dialysis. However, transplantation is not universally chosen by patients with renal failure, and limited knowledge about the survival benefit of transplantation versus dialysis may play a role. We created a mobile application clinical decision aid called iChoose Kidney to improve access to individualized prognosis information comparing dialysis and transplantation outcomes. METHODS: We describe the iChoose Kidney study, a randomized controlled trial designed to test the clinical efficacy of a mobile health decision aid among end-stage renal disease patients referred for kidney transplantation at 3 large, diverse transplant centers across the United States. Approximately 450 patients will be randomized to receive either (i) standard of care or “usual” transplantation education, or (ii) standard of care plus iChoose Kidney. RESULTS: The primary outcome is change in knowledge about the survival benefit of kidney transplantation versus dialysis from baseline to immediate follow-up; secondary outcomes include change in treatment preferences, improved decisional conflict, and increased access to kidney transplantation. Analyses are also planned to examine effectiveness across subgroups of race, socioeconomic status, health literacy, and health numeracy. DISCUSSION: Engaging patients in health care choices can increase patient empowerment and improve knowledge and understanding of treatment choices. If the effectiveness of iChoose Kidney has a greater impact on patients with low health literacy, lower socioeconomic status, and minority race, this decision aid could help reduce disparities in access to kidney transplantation.
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spelling pubmed-50122772016-09-06 A Randomized Controlled Trial of a Mobile Clinical Decision Aid to Improve Access to Kidney Transplantation: iChoose Kidney Patzer, Rachel E. Basu, Mohua Mohan, Sumit Smith, Kayla D. Wolf, Michael S. Ladner, Daniela P. Friedewald, John J. Chiles, Mariana C. Russell, Allison L. McPherson, Laura J. Gander, Jennifer C. Pastan, Stephen O. Kidney Int Rep Clinical Trial: Study Design INTRODUCTION: Kidney transplantation is the preferred treatment for patients with end-stage renal disease, as it substantially increases a patient’s survival and is cost-saving compared to a lifetime of dialysis. However, transplantation is not universally chosen by patients with renal failure, and limited knowledge about the survival benefit of transplantation versus dialysis may play a role. We created a mobile application clinical decision aid called iChoose Kidney to improve access to individualized prognosis information comparing dialysis and transplantation outcomes. METHODS: We describe the iChoose Kidney study, a randomized controlled trial designed to test the clinical efficacy of a mobile health decision aid among end-stage renal disease patients referred for kidney transplantation at 3 large, diverse transplant centers across the United States. Approximately 450 patients will be randomized to receive either (i) standard of care or “usual” transplantation education, or (ii) standard of care plus iChoose Kidney. RESULTS: The primary outcome is change in knowledge about the survival benefit of kidney transplantation versus dialysis from baseline to immediate follow-up; secondary outcomes include change in treatment preferences, improved decisional conflict, and increased access to kidney transplantation. Analyses are also planned to examine effectiveness across subgroups of race, socioeconomic status, health literacy, and health numeracy. DISCUSSION: Engaging patients in health care choices can increase patient empowerment and improve knowledge and understanding of treatment choices. If the effectiveness of iChoose Kidney has a greater impact on patients with low health literacy, lower socioeconomic status, and minority race, this decision aid could help reduce disparities in access to kidney transplantation. Elsevier 2016-04-11 /pmc/articles/PMC5012277/ /pubmed/27610423 http://dx.doi.org/10.1016/j.ekir.2016.04.001 Text en © 2016 International Society of Nephrology. Published by Elsevier Inc. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Clinical Trial: Study Design
Patzer, Rachel E.
Basu, Mohua
Mohan, Sumit
Smith, Kayla D.
Wolf, Michael S.
Ladner, Daniela P.
Friedewald, John J.
Chiles, Mariana C.
Russell, Allison L.
McPherson, Laura J.
Gander, Jennifer C.
Pastan, Stephen O.
A Randomized Controlled Trial of a Mobile Clinical Decision Aid to Improve Access to Kidney Transplantation: iChoose Kidney
title A Randomized Controlled Trial of a Mobile Clinical Decision Aid to Improve Access to Kidney Transplantation: iChoose Kidney
title_full A Randomized Controlled Trial of a Mobile Clinical Decision Aid to Improve Access to Kidney Transplantation: iChoose Kidney
title_fullStr A Randomized Controlled Trial of a Mobile Clinical Decision Aid to Improve Access to Kidney Transplantation: iChoose Kidney
title_full_unstemmed A Randomized Controlled Trial of a Mobile Clinical Decision Aid to Improve Access to Kidney Transplantation: iChoose Kidney
title_short A Randomized Controlled Trial of a Mobile Clinical Decision Aid to Improve Access to Kidney Transplantation: iChoose Kidney
title_sort randomized controlled trial of a mobile clinical decision aid to improve access to kidney transplantation: ichoose kidney
topic Clinical Trial: Study Design
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5012277/
https://www.ncbi.nlm.nih.gov/pubmed/27610423
http://dx.doi.org/10.1016/j.ekir.2016.04.001
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