Promoting Informed Decision-making on Renal Replacement Therapy: a Multicenter Randomized Controlled Trial
E.K. Massey1, P.J.H. Smak Gregoor2, R.W. Nette3, M.A. van den Dorpel4, A. van Kooij4, R. Zietse1, W.C. Zuidema1, R. Timman1, J. J.V. Busschbach1, W. Weimar1
1Erasmus MC, The Netherlands
2Albert Schweitzer Ziekenhuis, The Netherlands
3Sint Franciscus Gasthuis, The Netherlands
4Maasstadziekenhuis, The Netherlands
We investigated the effectiveness of an intervention to promote informed decision-making on primary renal replacement therapy (RRT) among patients with ESRD and members of their social network (attendees). In a multicentre randomised controlled trial 40 patients received home-based group education and 40 patients received standard education. 310 attendees participated. TPB concepts were measured in a pre-post design: knowledge, communication, attitude, self-efficacy, anticipated negative affect, and subjective and moral norm. In the intervention group significant increases were observed in knowledge (d=1.1; p<.001), communication (d=0.2; p=.13), attitude toward haemodialysis (d=0.5; p=.01), and subjective and moral norm (d=0.5; p=.02) while no changes were observed in the control group. In the intervention group no change was found in anticipated affect (d=-0.1; p=.65) while the controls showed a significant decrease (d=0.6; p=.003). There were also significant increases among attendees in knowledge (p<.001) and communication (p<.001). Early, out-reaching, group education supports informed decision-making regarding primary treatment for ESRD and may facilitate PKT.