Kidney Failure, Chronic Clinical Trial
Official 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
This study will test the feasibility of carrying out a randomised controlled trial, incorporating a mixed methods process evaluation, to evaluate advance care planning with older patients who have end-stage kidney disease.
Kidney failure becomes more common as people age. It increases the risks of other major
illnesses, sudden worsening of symptoms, and death. Even so, many people with kidney failure
do not talk about their preferences for end-of-life care.
Advance care planning (ACP) can help patients and families think through their preferences
for future care and discuss these with the professionals looking after them. This may lead to
care more in keeping with patients' wishes and so reduce distress for patients and families.
ACP is recommended as good practice for people with kidney failure.
However, questions remain about the impact of ACP on patients and families; and also about
the best ways to put ACP into practice. Doing research about ACP is challenging for everyone
involved, so we need to thoroughly test our research methods in a pilot study before we
attempt a larger study that would fully answer those questions.
To test our methods we will carry out a small-scale randomised controlled trial comparing
those patients who use ACP with those who do not, in terms of: quality of life, anxiety,
depression, physical functioning, well-being, satisfaction with decision-making and agreement
between the patient and their nominated carer in terms of the patient's preferences for care
at the end of life.
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