Interactive decision aid on therapy decision making for patients with chronic kidney disease: A prospective exploratory pilot study
Objective Patients with advanced chronic kidney disease (CKD) face challenging decisions about kidney replacement therapy (KRT) options. This study aimed to evaluate the effectiveness of an Interactive Patient-Decision-Aid App for Kidney Replacement Therapy (iPtDA-KRT App) in improving decision self...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2025-04-01
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| Series: | Digital Health |
| Online Access: | https://doi.org/10.1177/20552076251332832 |
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| Summary: | Objective Patients with advanced chronic kidney disease (CKD) face challenging decisions about kidney replacement therapy (KRT) options. This study aimed to evaluate the effectiveness of an Interactive Patient-Decision-Aid App for Kidney Replacement Therapy (iPtDA-KRT App) in improving decision self-efficacy, knowledge, and readiness while reducing decisional conflict and regret among patients with advanced CKD. Methods A prospective, two-arm clinical trial was conducted with 70 patients who used either the mobile app-based iPtDA-KRT or a paper-based PtDA for 4 weeks. Key measures included decision self-efficacy (DSES), decisional conflict (DCS), KRT knowledge (KRTKS), preparation for decision-making (PrepDM), and decision regret (DRS). These measures were assessed immediately post-intervention and at 4 weeks post-intervention. Additionally, outcomes such as DSES, DCS, and DRS were tracked at 8 weeks post-intervention. Data were analyzed using generalized estimating equations. Results The experimental group included 19 male and 16 female patients with a mean age of 66.4 ± 14.0 years, while the control group included 22 male and 13 female patients with a mean age of 59.7 ± 16.1 years. The experimental group demonstrated significantly greater and sustained improvements in self-efficacy, knowledge, and preparation for decision-making compared to the control group. Reductions in decisional conflict and regret were also maintained over time. Conclusions The iPtDA-KRT App demonstrated substantial and lasting benefits over paper-based PtDAs in supporting patients’ complex decision-making. These findings suggest that digital, interactive PtDAs may enhance informed decision-making, reduce long-term decisional conflict, and improve patient confidence in clinical settings. Trial Registration This study was registered at ClinicalTrials.gov (Identifier: NCT05666544). |
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| ISSN: | 2055-2076 |