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 (%) | 41 | 38 | 44 | 0.54 |
| Pre-education preference for supportive care (%) | 21 | 26 | 16 | 0.22 |
| Post-education knowledge of supportive care (%) | 61 | 58 | 64 | 0.54 |
| Post-education preference for supportive care (%) | 26 | 30 | 22 | 0.36 |