Lalita Subramanian|Junhui Zhao|Jarcy Zee|Megan Knaus|Angela Fagerlin|Erica Perry|June Swartz|Margie McCall|Nicole Bryant|Francesca Tentori
Use of a Decision Aid for Patients Considering Peritoneal Dialysis and In-Center Hemodialysis: A Randomized Controlled Trial
Arbor Research Collaborative for Health|Arbor Research Collaborative for Health|Arbor Research Collaborative for Health|University of Michigan–Ann Arbor|Center for Innovation|University of Utah|University of Michigan–Ann Arbor|DaVita Clinical Research (United States)|Vanderbilt University
annually 100000 us patients face difficult choice common dialysis types incenter hemodialysis peritoneal dialysis study evaluated value new decision aid assist choice dialysis modalitya parallelgroup randomized controlled trial test efficacy decision aid decisionmaking outcomesenglishspeaking us adults advanced chronic kidney disease internet access enrolled 2015participants randomly assigned decision aid intervention received information chronic kidney disease peritoneal dialysis hemodialysis value clarification exercise study website using electronic devices participants control arm required complete control questionnaire questionnaire responses used assess differences across arms decisionmaking outcomestreatment preference decisional conflict decision selfefficacy knowledge preparation decision makingof 234 consented participants 94 402 lost followup starting study among 140 70 arm started study 7 subsequently lost followup decision aid users lower decisional conflict scores 425 vs 291 p0001 higher average knowledge scores 903 vs 765 p0001 arms high decisional selfefficacy scores independent decision aid use uncertainty choice dialysis treatment declined 46 16 using decision aid almost 90 users decision aid reported helped decision makinglimited generalizability study selfselected study participants internet access speak english computer literacy high postrandomization loss followup evaluation shortterm outcomesthe decision aid improves decisionmaking outcomes immediately use implementation decision aid clinical practice may allow assessment effects patient engagement empowerment choosing dialysis modalitythis study funded patient centered outcomes research institute pcori award 1109registered clinicaltrialsgov study number nct02488317