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Lookup NU author(s): Emeritus Professor Richard Thomson, Dr Charlie Tomson
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).
© The Author 2016. Published by Oxford University Press on behalf of ERA-EDTA.Background Shared decision making is considered an important aspect of chronic disease management. We explored the feasibility of routinely measuring kidney patients' involvement in making decisions about renal replacement therapy (RRT) in National Health Service settings. Methods We disseminated a 17-item paper questionnaire on involvement in decision-making among adult patients with established kidney failure who made a decision about RRT in the previous 90 days (Phase 1) and patients who had been receiving RRT for 90-180 days (Phase 2). Recruitment rates were calculated as the ratio between the number of included and expected eligible patients (I: E ratio). We assessed our sample's representativeness by comparing demographics between participants and incident patients in the UK Renal Registry. Results Three hundred and five (Phase 1) and 187 (Phase 2) patients were included. For Phase 1, the I: E ratio was 0.44 (range, 0.08-2.80) compared with 0.27 (range, 0.04-1.05) in Phase 2. Study participants were more likely to be white compared with incident RRT patients (88 versus 77%; P < 0.0001). We found no difference in age, gender or social deprivation. In Phases 1 and 2, the majority reported a collaborative decision-making style (73 and 69%), and had no decisional conflict (85 and 76%); the median score for shared decision-making experience was 12.5 (Phase 1) and 10 (Phase 2) out of 20. Conclusion Our study shows the importance of assessing the feasibility of data collection in a chronic disease context prior to implementation in routine practice. Routine measurement of patient involvement in established kidney disease treatment decisions is feasible, but there are challenges in selecting the measure needed to capture experience of involvement, reducing variation in response rate by service and identifying when to capture experience in a service managing people's chronic disease over time.
Author(s): Durand M-A, Bekker HL, Casula A, Elias R, Ferraro A, Lloyd A, Van Der Veer SN, Metcalfe W, Mooney A, Thomson RG, Tomson CRV
Publication type: Article
Publication status: Published
Journal: Clinical Kidney Journal
Year: 2016
Volume: 9
Issue: 2
Pages: 252-259
Print publication date: 01/04/2016
Online publication date: 05/03/2016
Acceptance date: 08/01/2016
Date deposited: 11/04/2017
ISSN (print): 2048-8505
ISSN (electronic): 2048-8513
Publisher: Oxford University Press
URL: https://doi.org/10.1093/ckj/sfw003
DOI: 10.1093/ckj/sfw003
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