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Published VersionCC BY-NC V4.0, Open Access
Journal article
Treatment decision-making and care among older adults with kidney failure: protocol for a multicentre, prospective observational cohort study with nested substudies and linked qualitative research (the Elderly Advanced CKD Programme)
BMJ Open, Vol.12, pp.1-11
2022
PMID: 36581411
Abstract
Introduction: Shared treatment decision-making and planning of care are fundamental in advanced chronic kidney disease (CKD) management. There are limited data on several key outcomes for the elderly population including survival, quality of life, symptom burden, changes in physical functioning and experienced burden of healthcare. Patients, caregivers and clinicians consequently face significant uncertainty when making life-impacting treatment decisions. The Elderly Advanced CKD Programme includes quantitative and qualitative studies to better address challenges in treatment decision-making and planning of care among this increasingly prevalent elderly cohort.
Methods and analysis: The primary component is OUTcomes of Older patients with Kidney failure (OUTLOOK), a multicentre prospective observational cohort study that will enrol 800 patients ≥75 years with kidney failure (estimated glomerular filtration rate ≤15 mL/min/1.73 m2) across a minimum of six sites in Australia. Patients entered are in the decision-making phase or have recently made a decision on preferred treatment (dialysis, conservative kidney management or undecided). Patients will be prospectively followed until death or a maximum of 4 years, with the primary outcome being survival. Secondary outcomes are receipt of short-term acute dialysis, receipt of long-term maintenance dialysis, changes in biochemistry and end-of-life care characteristics. Data will be used to formulate a risk prediction tool applicable for use in the decision-making phase. The nested substudies Treatment modalities for the InfirM ElderLY with end stage kidney disease (TIMELY) and Caregivers of The InfirM ElderLY with end stage kidney disease (Co-TIMELY) will longitudinally assess quality of life, symptom burden and caregiver burden among 150 patients and 100 caregivers, respectively. CONsumer views of Treatment options for Elderly patieNts with kiDney failure (CONTEND) is an additional qualitative study that will enrol a minimum of 20 patients and 20 caregivers to explore experiences of treatment decision-making and care.
Details
- Title
- Treatment decision-making and care among older adults with kidney failure: protocol for a multicentre, prospective observational cohort study with nested substudies and linked qualitative research (the Elderly Advanced CKD Programme)
- Authors
- Amanda Siriwardana (Corresponding Author) - The University of SydneyNicholas A Gray (Author) - University of the Sunshine Coast, Queensland, School of Health and Behavioural Sciences - LegacyAngela Makris (Author) - UNSW SydneyChenlei Kelly Li (Author) - St George HospitalKenneth Yong (Author) - UNSW SydneyYachna Mehta (Author) - The George Institute for Global HealthJannel Ramos (Author) - The George Institute for Global HealthGian Luca Di Tanna (Author) - The George Institute for Global HealthChris Gianacas (Author) - The George Institute for Global HealthIsaac Yeboah Addo (Author) - UNSW SydneySarah Roxburgh (Author) - Royal North Shore HospitalVasi Naganathan (Author) - The University of SydneyCeline Foote (Author) - Concord Repatriation General HospitalMartin Gallagher (Author) - Liverpool Hospital
- Publication details
- BMJ Open, Vol.12, pp.1-11
- Publisher
- BMJ Group
- Date published
- 2022
- DOI
- 10.1136/bmjopen-2022-066156
- ISSN
- 2044-6055; 2044-6055
- PMID
- 36581411
- Copyright note
- © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.orglicenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
- Organisation Unit
- UniSC Clinical Trials Centre; University of the Sunshine Coast, Queensland; School of Health and Behavioural Sciences - Legacy
- Language
- English
- Record Identifier
- 99698398502621
- Output Type
- Journal article
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