Advance Care Planning Coaching in CKD Clinics: A Pragmatic Randomized Clinical Trial. (Record no. 754)

MARC details
000 -LEADER
fixed length control field 04491nam a22005897a 4500
008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION
fixed length control field 220222s20212021 xxu||||| |||| 00| 0 eng d
024 ## - OTHER STANDARD IDENTIFIER
Standard number or code 10.1053/j.ajkd.2021.08.019 [doi]
024 ## - OTHER STANDARD IDENTIFIER
Standard number or code S0272-6386(21)00896-9 [pii]
040 ## - CATALOGING SOURCE
Original cataloging agency Ovid MEDLINE(R)
099 ## - LOCAL FREE-TEXT CALL NUMBER (OCLC)
PMID 34648897
245 ## - TITLE STATEMENT
Title Advance Care Planning Coaching in CKD Clinics: A Pragmatic Randomized Clinical Trial.
251 ## - Source
Source American Journal of Kidney Diseases. 79(5):699-708.e1, 2022 May.
252 ## - Abbreviated Source
Abbreviated source Am J Kidney Dis. 79(5):699-708.e1, 2022 May.
252 ## - Abbreviated Source
Former abbreviated source Am J Kidney Dis. 2021 Oct 12
253 ## - Journal Name
Journal name American journal of kidney diseases : the official journal of the National Kidney Foundation
260 ## - PUBLICATION, DISTRIBUTION, ETC.
Year 2022
260 ## - PUBLICATION, DISTRIBUTION, ETC.
Manufacturer FY2022
260 ## - PUBLICATION, DISTRIBUTION, ETC.
Publication date 2021 Oct 12
265 ## - SOURCE FOR ACQUISITION/SUBSCRIPTION ADDRESS [OBSOLETE]
Publication status ppublish
266 ## - Date added to catalog
Date added to catalog 2022-02-22
268 ## - Previous citation
-- American Journal of Kidney Diseases. 2021 Oct 12
501 ## - WITH NOTE
Local holdings Available online from MWHC library: 1999 - present, Available in print through MWHC library: 1999 - 2006
520 ## - SUMMARY, ETC.
Abstract CONCLUSIONS: Individualized coaching may be effective in enhancing ACP, but its impact may be influenced by the health care environment where it is delivered.
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Abstract FUNDING: The Patrick and Catherine Weldon Donaghue Medical Research Foundation, via the Greater Value Portfolio.
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Abstract INTERVENTION: Nurses or social workers with experience in nephrology or palliative care delivered individualized in-person ACP sessions. The enhanced control group was given Make Your Wishes About You (MY WAY) education materials and was verbally encouraged to bring their completed advance directives to the clinic.
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Abstract LIMITATIONS: Small number of study sites and possible unrepresentativeness of the broader CKD population by study participants.
520 ## - SUMMARY, ETC.
Abstract OUTCOME: Primary outcome measures were scores on a 45-point ACP engagement scale at 14 weeks and a documented advance directive or portable medical order at 16 weeks after enrollment.
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Abstract RATIONALE & OBJECTIVE: Although guidelines recommend more and earlier advance care planning (ACP) for patients with chronic kidney disease (CKD), scant evidence exists to guide incorporation of ACP into clinical practice for patients with stages of CKD prior to kidney failure. Involving nephrology team members in addition to primary care providers in this important patient-centered process may increase its accessibility. Our study examined the effect of coaching implemented in CKD clinics on patient engagement with ACP.
520 ## - SUMMARY, ETC.
Abstract RESULTS: Among 254 participants analyzed, 46.5% were 65-74 years of age, and 54% had CKD stage 3. The coached patients scored 1.9 points higher at 14 weeks on the ACP engagement scale (beta = 1.87 [95% CI, 0.13-3.64]) adjusted for baseline score and site. Overall, 32.8% of intervention patients (41 of 125) had an advance directive compared with 17.8% (23 of 129) of patients in the control group. In a site-adjusted multivariable model, coached patients were 79% more likely to have a documented advance directive or portable medical order (adjusted risk ratio, 1.79 [95% CI, 1.18-2.72]), with the impact principally evident at only 1 study site.
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Abstract SETTING & PARTICIPANTS: Three CKD clinics in different states participated: 273 patients consented to participate, 254 were included in analysis. Eligible patients were 55 years or older, had stage 3-5 CKD, and were English speaking.
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Abstract STUDY DESIGN: Multicenter, pragmatic randomized controlled trial.
520 ## - SUMMARY, ETC.
Abstract TRIAL REGISTRATION: Registered at ClinicalTrials.gov with study number NCT03506087. Copyright (c) 2021 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
546 ## - LANGUAGE NOTE
Language note English
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element *Advance Care Planning
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element *Mentoring
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element *Renal Insufficiency, Chronic
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Advance Directives
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Female
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Humans
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Male
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Patient Participation
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element Renal Insufficiency, Chronic/th [Therapy]
651 ## - SUBJECT ADDED ENTRY--GEOGRAPHIC NAME
Institution MedStar Washington Hospital Center
656 ## - INDEX TERM--OCCUPATION
Department Medicine/Nephrology
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Department Medicine/Palliative Care
657 ## - INDEX TERM--FUNCTION
Medline publication type Journal Article
700 ## - ADDED ENTRY--PERSONAL NAME
Local Authors Groninger, Hunter
700 ## - ADDED ENTRY--PERSONAL NAME
Local Authors Sherman, Michael J
790 ## - Authors
All authors Aiello JR, Aldous A, Anderson E, Groninger H, Lupu DE, Schell JO, Sherman MJ, Simmens SJ
856 ## - ELECTRONIC LOCATION AND ACCESS
DOI <a href="https://dx.doi.org/10.1053/j.ajkd.2021.08.019">https://dx.doi.org/10.1053/j.ajkd.2021.08.019</a>
Public note https://dx.doi.org/10.1053/j.ajkd.2021.08.019
942 ## - ADDED ENTRY ELEMENTS (KOHA)
Koha item type Journal Article
Item type description Article
Holdings
Withdrawn status Lost status Damaged status Not for loan Collection Home library Current library Date acquired Total Checkouts Full call number Barcode Date last seen Price effective from Koha item type
          MedStar Authors Catalog MedStar Authors Catalog 02/22/2022   34648897 34648897 02/22/2022 02/22/2022 Journal Article

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