Web-based Advance Care Planning Intervention for Patients With Kidney Failure on Dialysis: Pilot Testing of 'My Voice'

NCT07309367 | Recruiting

• 1 other identifier: NUS-IRB-2024-713
• Study Type: interventional
• Target: 100
• Locations: 1 country
• Sites: 1

Brief Summary

'My Voice' is a website intervention developed to enable advance care planning (ACP) conversations for patients with kidney disease on dialysis, educate patients on their illness, help identify their goals and preferences for EOL care, and coaches them on how to speak with their HCPs and loved ones. This study aims to evaluate if 'My Voice' intervention improves quality of ACP conversations between patients and providers, and patients and family carers; improves patient's knowledge about kidney failure, engagement in ACP and preparedness for future end of life care compared to usual practices for ACP in dialysis centres.

Conditions

Kidney Failure, Chronic Therapy; Hemodialysis

Keywords

Advance care planning; Web intervention; Dialysis withdrawal

Outcome Measures

Primary Outcomes (1)

• Quality of ACP conversations (serious illness conversations) between patients and physicians/health care providers

  Quality of ACP conversations will be measured using a scoring sheet developed for the study. One point will be given for every SICG topic discussed with score min to max of 0 to 13. Higher scores indicate higher quality.

  Post baseline and within 8 weeks

Other Outcomes (4)

• Change in kidney disease and dialysis knowledge scores

  Baseline to 8 weeks

• Change in ACP engagement

  Baseline to 8 weeks

• Change in patient preparedness

  Baseline to 8 weeks

Study Arms (2)

Intervention group

EXPERIMENTAL

Patients will view My Voice website intervention and complete patient module. They will also receive standard of care for advance care planning \[namely serious illness conversation (SIC)\] with the health care provider at the dialysis centers. Caregivers will view My Voice website intervention and complete caregiver module.

Other: My Voice website intervention with patient and caregiver modules

Usual care group

NO INTERVENTION

Patients will receive standard of care for advance care planning -namely the serious illness conversation (SIC) with the health care provider at the dialysis centres. Caregivers will receive no intervention.

Interventions

My Voice website intervention with patient and caregiver modules OTHER

'My Voice' is an interactive web-based ACP intervention tailored for patients with kidney failure on dialysis, and their caregivers, and includes patient and caregiver modules. Patient module has 6 steps consisting of a series of videos, value-clarification exercise (VCE) identifying goals and values for care, and knowledge quiz, and a summary My Voice document that is generated shared with patients, designated surrogates and HCPs. Automated reminders are sent to revisit My Voice. Caregiver module has 4 steps with videos and quiz, with access to their loved one's summary My Voice document containing goals of care and values.

Intervention group

Eligibility Criteria

• Age: 21 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Singapore citizens or permanent residents; aged 21 years (age of majority) or older
• CKD stage 5; receiving dialysis
• Identified as eligible for SIC by NKF HCPs based on one or more of the following:
• clinical deterioration with a terminal condition or
• intolerability to dialysis or
• having two or more unplanned hospitalizations for renal complications in the past 6 months (from medical records); or
• known to palliative care or under conservative care as indicated in the discharge summary or
• poor functional status indicated by the Fragility Assessment for Elders (FIFE) score \>4
• Normal cognitive function as indicated by Mini Mental Scale Examination (MMSE) score of 24 or more (based on medical record)
• Able to speak and read English, Mandarin or Malay
• Agreeable to be audio-recorded
• Aged 21 years old and above
• Family caregivers of the patients recruited i.e. Caregiver primarily involved in providing care, ensuring provision of care, and/or in making decisions regarding patient's care, with no expectation of financial compensation
• Able to speak and read English, Mandarin or Malay
• Have a phone and/or an electronic device with internet access.

You may not qualify if:

• Patients with cognitive impairment or serious mental illness will be excluded
• Patients who had prior serious illness conversations (SIC) will be excluded
• Are not easily contactable via mobile phone or landline
• Those who are foreign domestic workers/maids
• Are not easily contactable via mobile phone or landline

Sponsors & Collaborators

• Duke-NUS Graduate Medical School: lead
• National Kidney Foundation, Singapore: collaborator

Study Sites (1)

Duke NUS Medical School

Singapore, Singapore

RECRUITING

MeSH Terms

Conditions

Renal Insufficiency

Condition Hierarchy (Ancestors)

Kidney Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Male Urogenital Diseases

Central Study Contacts

Chandrika Ramakrishnan, MBBS; MPH

CONTACT

+6566011253; chandrika.ramky@duke-nus.edu.sg

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Research Fellow

Study Record Dates

• First Submitted: September 23, 2025
• First Posted: December 30, 2025
• Study Start: October 2, 2025
• Primary Completion (Estimated): September 30, 2026
• Study Completion (Estimated): December 30, 2026
• Last Updated: December 30, 2025

Record last verified: 2025-11

Data Sharing

• IPD Sharing: Will not share

Locations

SG (1)