Aid Improves Decision Quality for Seniors With CKD

For older adults with CKD, a decision aid about kidney replacement therapy improves decision quality and clarifies treatment preferences, according to a study published in the Annals of Internal Medicine. Keren Ladin, PhD, and colleagues examined whether the Decision-Aid for Renal Therapy (DART) improved decisional quality versus usual care in a multicenter trial conducted at eight outpatient nephrology clinics. Overall, 363 older adults were randomly assigned to usual care or DART (180 and 183, respectively). Change in the decisional conflict scale (DCS) score was examined from baseline to 3, 6, 12, and 18 months. An improvement in decisional quality with DART was observed, with the mean DCS score decreasing relative to control (mean difference, -7.9 and -8.5 at 3 and 6 months, respectively); results decreased after 6 months. Knowledge improved with DART versus usual care at 3 months (mean difference, 7.2); findings were similar at 6 months and then decreased at 18 months (mean difference, 5.9).