Advance care planning with patients who have end-stage kidney disease

  • Research type

    Research Study

  • Full title

    Advance care planning with older patients who have end-stage kidney disease: Feasibility of a deferred entry randomised controlled trial incorporating a mixed methods process evaluation

  • IRAS ID

    193402

  • Contact name

    Peter D O'Halloran

  • Contact email

    p.ohalloran@qub.ac.uk

  • Sponsor organisation

    Queen's University Belfast

  • Clinicaltrials.gov Identifier

    NCT02631200

  • Duration of Study in the UK

    2 years, 0 months, 1 days

  • Research summary

    Title: Is it feasible to conduct a randomised controlled trial to evaluate advance care planning (ACP) with older patients who have kidney failure?

    Background: Chronic kidney disease and kidney failure (end-stage kidney disease - ESKD) become more common as people age. They increase the risks of other major illnesses and sudden death. However, many people with ESKD do not discuss their preferences for end-of-life care with their families or healthcare professionals. ACP can help patients think through their preferences for future care and discuss these with professionals. This may lead to care more in keeping with patients’ wishes and so reduce distress for patients and families. Consequently, ACP is recommended as good practice for people with ESKD. However, we still need to find out more about the impact of ACP on patients and families; and also about the best ways to put it into practice. This study is designed to test the research methods for a larger study that would answer those questions.

    Aim: To determine the feasibility of conducting a deferred entry RCT, alongside a mixed methods study, to evaluate ACP with patients who have ESKD.

    Objectives are to investigate the acceptability of the ACP intervention to patients, their carers and professionals; the costs and the best ways to deliver ACP; and to pilot all the methods and procedures that would be needed in a larger definitive study.

    Methods: Denying the opportunity for ACP would be unethical, so 40 patient/carer pairs receiving dialysis in two Health and Social Care Trusts in Northern Ireland will be randomised in a 12 week RCT to immediate or deferred entry groups to allow us to compare the groups, before the deferred entry group proceeds to ACP. We will also pilot methods assessing cost effectiveness, and use qualitative methods to identify key factors for successful use of ACP.

  • REC name

    HSC REC A

  • REC reference

    16/NI/0043

  • Date of REC Opinion

    15 Apr 2016

  • REC opinion

    Further Information Favourable Opinion