Effect of the iChoose Kidney Decision Aid in Improving Knowledge about Treatment Options among Transplant Candidates: a Randomized Controlled Trial.
Patzer RE, McPherson L, et al.American Journal of Transplantation 2018; 18(8): 1954-1965.
Aims
To analyse the effect of a mobile and web-based decision aid (iChoose Kidney) on improving patient knowledge and access to kidney transplantation.
Interventions
Participants were randomised to receive centre-specific standard of care education about kidney transplant, either with the supplemental use of iChoose Kidney (intervention), or without (control).
Participants
470 end-stage renal disease patients aged 18-70 years awaiting kidney transplant, with no previous solid or multi-organ transplant, and no severe cognitive or visual impairment.
Outcomes
The primary measured outcome was the change in patient knowledge about the survival benefits of kidney transplant. Secondary measured outcomes included access to transplant, decisional conflict, patient treatment preferences and provider opinions.
Follow-up
3 months
CET Conclusions
This RCT evaluated whether the mobile and web-based decision aid (iChoose Kidney) could improve patient knowledge about the benefits of kidney transplantation compared to dialysis among patients evaluated for kidney transplantation. Patients were recruited from three transplant centres and randomised using a random number generator application via iPad to center-specific standard of care education about kidney transplant with or without use of iChoose Kidney during the transplant evaluation by the nephrologist or surgeon. The sample size calculation showed that 420 participants were needed to achieve a power of 80%. Of the 470 patients that were recruited and randomised, 443 patients were included in the final population. Patients in the iChoose Kidney group showed a larger change in transplant knowledge scores compared to the control group. However, use of iChoose Kidney did not improve access to transplantation according to the composite metric for transplant access.
Data analysis
Available case analysis
Trial registration
Clinicaltrials.gov - NCT02235571