Nephrology · 2 h ago
Toolkit for ESKD Life Plan Shows Favorable Preliminary Acceptability
A cross-sectional survey evaluated a co-developed toolkit intended to support shared decisions about kidney replacement therapy and vascular access. Among 63 participants who completed at least half of the survey, ratings of the written materials and videos were favorable, though the study assessed acceptability rather than clinical outcomes.
- Toolkit co-developed with patients, supporters, and clinicians
- 63 of 128 participants completed at least half the survey
- At least 89% favorable agreement on materials and videos
- Evaluation measured acceptability, not clinical outcomes
The ESKD Life Plan is a patient-centered approach to planning kidney replacement therapy (KRT) and vascular access, recommended in the 2019 KDOQI vascular access guideline. Researchers developed a toolkit with input from patients, supportive others, and clinicians, drawing on earlier qualitative research. It covers care-team identification, patient goals and values, KRT education, treatment selection, and Life Plan completion. After iterative refinement, the team conducted a cross-sectional survey using the Patient Education Materials Assessment Tool (PEMAT).
Of 128 survey participants, 63 (49.2%) completed at least half of the survey items: 25 patients, 17 supportive others, and 12 clinicians. At least 89% of respondents agreed favorably with ratings of the written materials and videos across PEMAT domains. Participants also recommended simplifying medical terminology, improving visual hierarchy, and providing an alternative to graphic clinical photographs.
The findings indicate preliminary acceptability among the respondents, not evidence that the toolkit improves decision quality, treatment selection, or patient outcomes. Fewer than half of survey participants completed at least half of the items, and the evaluation was cross-sectional. The toolkit operationalizes a guideline-aligned, values-focused approach, but its impact on implementation and clinical outcomes remains to be established.
In practice
For adults with end-stage kidney disease facing kidney replacement therapy and vascular-access decisions, the toolkit offers structured education and values elicitation aligned with the 2019 KDOQI Life Plan approach. Its preliminary survey found favorable ratings among participating patients, supportive others, and clinicians, but it did not test whether the resource improves shared decision-making, treatment choices, or health outcomes. The cross-sectional evaluation had substantial incomplete responses, so these findings support acceptability rather than a change in clinical practice.
AI-generated clinical interpretation · Not editor-reviewed
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Journal of General Internal Medicine: Development and Preliminary Evaluation of a Toolkit Aimed at Improving Implementation of the End-Stage Kidney Disease Life Plan ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.