Advance Care Planning With Older Patients Who Have End-stage Kidney Disease (ACREDiT)

Queen's University Belfast

Status: Completed

Conditions: Kidney Failure, Chronic

Treatments: Behavioral: Advance care plan

Study type: Interventional

Funder types: Other

Identifiers

NCT02631200

20724-1

Details and patient eligibility

About

This study will test the feasibility of carrying out a randomised controlled trial, incorporating a mixed methods process evaluation, to evaluate advance care planning with older patients who have end-stage kidney disease.

Full description

Kidney failure becomes more common as people age. It increases the risks of other major illnesses, sudden worsening of symptoms, and death. Even so, many people with kidney failure do not talk about their preferences for end-of-life care.

Advance care planning (ACP) can help patients and families think through their preferences for future care and discuss these with the professionals looking after them. This may lead to care more in keeping with patients' wishes and so reduce distress for patients and families. ACP is recommended as good practice for people with kidney failure.

However, questions remain about the impact of ACP on patients and families; and also about the best ways to put ACP into practice. Doing research about ACP is challenging for everyone involved, so we need to thoroughly test our research methods in a pilot study before we attempt a larger study that would fully answer those questions.

To test our methods we will carry out a small-scale randomised controlled trial comparing those patients who use ACP with those who do not, in terms of: quality of life, anxiety, depression, physical functioning, well-being, satisfaction with decision-making and agreement between the patient and their nominated carer in terms of the patient's preferences for care at the end of life.

Enrollment: 36 patients

Sex: All

Ages: 65+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Attending the renal units taking part in the study
• Receiving renal replacement therapy
• Capacity to understand, retain, and weigh the necessary information and communicate their decisions
• Identified by their consultant as having worsening symptoms, functional decline, and two or more co-morbidities.

Exclusion criteria

• Expected to die in the next three months

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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36 participants in 2 patient groups

Advance care plan

Experimental group

Description:

Participants will be offered the opportunity to complete an advance care plan.

Treatment:

Behavioral: Advance care plan

Usual care

No Intervention group

Description:

Participants will be offered usual care for 12 weeks (and only then be offered the opportunity to complete an advance care plan).