Study Protocol for ‘Patient Referral and Education Program prior to Renal Replacement Therapy (PREP-RRT)”:

A Pilot and Feasibility Study

Abstract

Patients with advanced stages of chronic kidney disease (CKD), especially racial minorities, often do not receive treatment or education until specific symptoms begin to manifest. The Patient Referral and Education Program prior to Renal Replacement Therapy (PREP-RRT) study is intended to capture the perspective of African Americans receiving renal care and then tailor education for hospitalized patients who may not be well linked to the medical system. In the U.S., African Americans and other minorities are less likely to be seen by a nephrologist prior to dialysis and the lack of pre-dialysis care and education is associated with lower likelihood of pre-emptive transplant. The primary outcome for the PREP-RRT study will be change in patient knowledge, attitudes and behavior about CKD treatment options which will be assessed by the previously validated Kidney Knowledge Survey (KiKS). Secondary outcomes of interest are patient satisfaction with education, time-to-event for nephrology appointment, appearance at transplant center, likelihood of fistula, self-care dialysis at dialysis initiation, or documentation of patient decision not to initiate RRT. The PREP RRT intervention will identify, educate and motivate patients to increase CKD self-care and to improve communication and shared decision-making about RRT treatments among patients, their families and their providers.