NCT03149328

Brief Summary

People living with end-stage kidney disease (ESKD) need dialysis or transplantation in order to stay alive. This illness and treatment significantly impact peoples' health, emotions, work and relationships. To promote person-centred care, healthcare professionals should be asking patients about what matters to them and using this feedback to plan and deliver care. Patient-reported outcome and experience questionnaires (jointly referred to as PROs) allow patients to provide information about their quality of life, symptoms and experiences with care. PROs are increasingly used to help healthcare professionals learn about what is important to patients and the impacts of illness or treatments from patients' point of view. Embedding feedback from patients into routine clinical practice is important in end-stage kidney disease because of the physical and quality of life challenges these patients face when living with kidney failure. PROs provide vital and often missing information that the healthcare team can use to support patients. However, PROs administered via paper questionnaires have been perceived as cumbersome, difficult to integrate with other health information and do not provide immediate feedback. In this research, home dialysis patients will have the opportunity to complete electronically administered PROs (ePROs) and healthcare professionals will receive education about how to use PRO information. The goal is to learn how to support healthcare professionals to routinely use this information to inform patient care, and see if this makes a difference in patients' symptoms, person-centred care, quality of life and satisfaction with care. Learning what matters most to patients is essential for healthcare professionals to provide person-centred care. This research will address the gap in our understanding of how to best use patients' reports in healthcare. Findings of this research may ultimately improve the quality of healthcare for Canadians living with end-stage kidney disease.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
594

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Aug 2017

Typical duration for not_applicable

Geographic Reach
1 country

2 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

May 1, 2017

Completed
10 days until next milestone

First Posted

Study publicly available on registry

May 11, 2017

Completed
4 months until next milestone

Study Start

First participant enrolled

August 28, 2017

Completed
2.2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

October 31, 2019

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

October 31, 2019

Completed
1.3 years until next milestone

Results Posted

Study results publicly available

March 5, 2021

Completed
Last Updated

October 5, 2021

Status Verified

September 1, 2021

Enrollment Period

2.2 years

First QC Date

May 1, 2017

Results QC Date

November 4, 2020

Last Update Submit

September 14, 2021

Conditions

Keywords

Home DialysisPerson-Centred CarePatient-Reported Outcome MeasuresProcess EvaluationEducational SupportElectronic Patient-Reported Outcome MeasuresPatient-Reported Experience Measures

Outcome Measures

Primary Outcomes (2)

  • Symptoms - Trajectory of Change

    Assessed using the symptoms/problems domain of the Kidney Disease Quality of Life 36-Item Short Form Survey (KDQOL-36). The Symptoms/Problems domain has 12 items, each representing a symptom or side effect of kidney disease based on the past 4 weeks with 5 response items ranging from "Not Bothered at all = 100" to "Extremely Bothered = 0". Min Score = 0; Max score = 100. Higher score indicates better health.

    Trajectories of up to 24 months from start of enrollment to study completion

  • Person-centred Care - Trajectory of Change

    Assessed using the Patient Assessment of Care for Chronic Conditions (PACIC-20), a patient-reported experience measure on satisfaction with care over the past 6 months. The PACIC-20 is a 20-item survey based on five subscales: (1) patient activation, (2) delivery system design and decision support, (3) goal setting and tailoring, (4) problem-solving and contextual counselling, and (5) follow-up and coordination. Each item is rated on a five-point scale (from "Almost never = 0" to "Almost always = 5") and the subscale and total scores are based on average scores across items. Min score = 0; Max score = 5. Higher scores indicates higher quality of care.

    Trajectories of up to 24 months from start of enrollment to study completion

Secondary Outcomes (4)

  • Utilization of Health Services

    From study enrollment until completion (up to 24 months)

  • Number of Participants Who Selected "1 - Excellent" on Satisfaction With Care

    Up to 24 months from start of enrollment to study completion

  • Mental Health - Trajectory of Change

    Trajectories of up to 24 months from start of enrollment to study completion

  • Quality of Life - Trajectory of Change

    Trajectories of up to 24 months from start of enrollment to study completion

Study Arms (2)

Northern Alberta Renal Program (NARP)

EXPERIMENTAL

Provide in NARP (intervention group), 1) an electronic tool (ePRO) that facilitates real time PRO data collection and feedback in clinical practice, and 2) educational support to multidisciplinary home dialysis clinicians about how to use PROs routinely in their practice.

Other: Educational Support

Southern Alberta Renal Program (SARP)

NO INTERVENTION

In SARP (comparator group), clinicians will not receive PRO feedback or education sessions.

Interventions

In the intervention group, clinicians will be provided with PRO feedback for use in their clinical practice. They will also receive educational support on how to use PRO data at point of care.

Northern Alberta Renal Program (NARP)

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • home dialysis patients attending regularly scheduled appointments in Edmonton at the Aberhart Clinic (NARP) or in Calgary at the Sheldon M. Chumir Health Centre (SARP)
  • ≥18 years old
  • able to read and speak English
  • can provide written informed consent
  • if a patient changes dialysis modality, they can continue to participate
  • all clinical staff working with home dialysis patients at the Aberhart clinic in Edmonton (NARP)
  • study co-investigators/collaborators who are NARP clinicians may choose to participate

You may not qualify if:

  • visual impairment
  • cannot read or speak English

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

Sheldon M. Chumir Health Centre

Calgary, Alberta, T2R 0X7, Canada

Location

Aberhart Centre

Edmonton, Alberta, T6G 2J3, Canada

Location

Related Publications (1)

  • Schick-Makaroff K, Klarenbach S, Kwon JY, Cohen SR, Czupryn J, Lee L, Pauly R, MacRae JM, Forde B, Sawatzky R. Electronic patient-reported outcomes in clinical kidney practice (ePRO Kidney): a process evaluation of educational support for clinicians. Ther Adv Chronic Dis. 2023 Jun 12;14:20406223231173624. doi: 10.1177/20406223231173624. eCollection 2023.

MeSH Terms

Conditions

Kidney Failure, Chronic

Interventions

Training Support

Condition Hierarchy (Ancestors)

Renal Insufficiency, ChronicRenal InsufficiencyKidney DiseasesUrologic DiseasesFemale Urogenital DiseasesFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesMale Urogenital DiseasesChronic DiseaseDisease AttributesPathologic ProcessesPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Financial SupportEconomicsHealth Care Economics and Organizations

Results Point of Contact

Title
Dr. Kara Schick-Makaroff
Organization
University of Alberta

Study Officials

  • Kara Schick-Makaroff, PhD

    University of Alberta

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
No
Restrictive Agreement
No

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NON RANDOMIZED
Masking
NONE
Purpose
HEALTH SERVICES RESEARCH
Intervention Model
PARALLEL
Model Details: Process evaluation with two phases (Phase 1: Usability Testing; Phase 2: Evaluation)
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Principal Investigator

Study Record Dates

First Submitted

May 1, 2017

First Posted

May 11, 2017

Study Start

August 28, 2017

Primary Completion

October 31, 2019

Study Completion

October 31, 2019

Last Updated

October 5, 2021

Results First Posted

March 5, 2021

Record last verified: 2021-09

Data Sharing

IPD Sharing
Will share

Upon completion of analysis, anonymous, quantitative data will be made available online indefinitely to the public on a database, such as Dataverse. Dataverse is a public repository and the University of Alberta provides the infrastructure support for sharing datasets. (See (http://dataverse.org/)

Shared Documents
STUDY PROTOCOL, SAP
Time Frame
Upon publication the data will be available indefinately
Access Criteria
Anyone with a dataverse account will have access to the data

Locations