Patient INformation About Options for Treatment - PINOT

Study Overview
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Brief Summary
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This prospective observational study is designed to find out what treatment options new patients with chronic kidney disease learn about from their renal unit. Aims: To determine the proportion of new CKD patients who receive information about treatment options prior to commencing dialysis, pre-emptive transplantation or conservative management. To determine the timing (i.e. patient's stage of disease) when information is given. To find out whether patients have a friend or family member with them when information is given. Research Design and methods: This study is an assessment of CKD education practices. Nephrologists and pre-dialysis coordinators from each renal unit will complete questionnaires about information that was given to each new dialysis, pre-emptive transplant or conservatively managed patient that started treatment during a 3 month period. Study hypothesis: Approximately one third of CKD patients will receive information after starting treatment. There will be a positive association between in-centre haemodialysis and later referral, non-English speaking background, and advancing age. Significance: The results from this national audit will provide Australian nephrologists and renal nurses with evidence about CKD education practices and compliance with clinical practice guidelines. The results may highlight opportunities for improvement in practice.

Detailed Description
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Additional research objectives and key research questions: 1. To determine the proportion of patients who receive information about: pre-emptive transplantation; peritoneal dialysis; home haemodialysis; centre based haemodialysis; supported non-dialytic care or conservative management. 3. To determine the proportion of incident patients that have a non-English speaking background (NESB) requiring an interpreter or translated materials. 4. To examine associations between age, gender, health insurance status, NESB, CKD stage and information provided on initial treatment commenced. 5. To determine the proportion of patients who choose not to dialyse.

Official Title
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Patient Information About Options for Treatment of Stage 5 Chronic Kidney Disease

Conditions
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Chronic Kidney Disease

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients attending Australian adult or pediatric renal units Patients with Stage 5 chronic kidney disease commencing dialysis or having a pre-emptive transplant or with decision made for conservative care and eGFR < 15ml/min/1.73m2 between 1st July and 30th September 2009 Exclusion Criteria: Patients with acute kidney injury not requiring chronic renal replacement therapy Patients with a failing kidney transplant returning to dialysis
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Stage 5 chronic kidney disease<br>Incident patients commencing renal replacement therapy or conservative care | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Proportion of incident Stage 5 CKD patients who receive information about their treatment options prior to commencing treatment |  | Time prior to commencement of treatment. eg. 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Stage of CKD (based on eGFR) when information about treatment options is first given |  | one time point prior to commencement of treatment | 
| Patient and unit characteristics associated with commencing renal replacement therapy versus conservative care |  | One time point based on commencement date of first treatment | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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chronic kidney disease, dialysis, pre dialysis education, transplantation, conservative care