iChoose Kidney Randomized Study

NCT02235571: iChoose decision kidney aid for end-stage renal disease patients

Description

The investigators developed iChoose Kidney—a shared decision-making support tool accessible through iPad, iPhone, or the internet—to provide end-stage renal disease (ESRD) patients and their providers with a simple, standardized, easily accessible, statistically robust tool for use in the clinical setting to guide patient education and healthcare decision-making regarding the treatment options of dialysis vs. kidney transplantation. iChoose Kidney provides patients with estimates of their individualized one and three-year risks of mortality on dialysis vs. transplantation, based on previous national data. The tool has the potential to improve communication and decision-making between patients and their healthcare providers as well as improve access to kidney transplantation among ESRD patients.

This two-arm, randomized study is being conducted at three large transplant centers with diverse patient populations. One group of patients received standard education alone during their scheduled transplant evaluation, while the second group received the standard education plus provider use of the iChoose Kidney aid.

The project timeline will be a total of 24 months inclusive of enrollment, follow-up, data analysis, and outcome evaluation. The study will assess the degree to which the iChoose decision aid improves patient knowledge, preferences for treatment, and patient access to transplant while also evaluating whether providers find the tool useful for sharing information with patients about options for treating their kidney disease.

Specific Aims

1. To determine the patient-, dialysis facility-, and neighborhood-level barriers to kidney transplantation in ESRD Network 6.

2. To develop a multilevel intervention to reduce racial disparities in access to kidney transplantation.

3. To determine the feasibility and effectiveness of a pilot intervention to reduce disparities in kidney transplant access in Georgia. It is hoped that the long-term impact of iChoose Kidney will be to reduce racial disparities in the kidney disease community.