Promoting Informed Decision-making on Renal Replacement Therapy: a Multicenter Randomized Controlled Trial


  • E.K. Massey
  • P.J.H. Smak Gregoor
  • R.W. Nette
  • M.A. van den Dorpel
  • A. van Kooij
  • R. Zietse
  • W.C. Zuidema
  • R. Timman
  • J. J.V. Busschbach
  • W. Weimar


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.






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