Putting patients at the center of kidney care transitions: PREPARE NOW, a cluster randomized controlled trial

J A Green; P L Ephraim; F F Hill-Briggs; T Browne; T S Strigo; C L Hauer; R A Stametz; J D Darer; U D Patel; K Lang-Lindsey; B L Bankes; S A Bolden; P Danielson; S Ruff; L Schmidt; A Swoboda; P Woods; B Vinson; D Littlewood; G Jackson; J F Pendergast; J St Clair Russell; K Collins; E Norfolk; I D Bucaloiu; S Kethireddy; C Collins; D Davis; J dePrisco; D Malloy; C J Diamantidis; S Fulmer; J Martin; D Schatell; N Tangri; A Sees; C Siegrist; J Breed Jr; A Medley; E Graboski; J Billet; M Hackenberg; D Singer; S Stewart; A Alkon; N A Bhavsar; L Lewis-Boyer; C Martz; C Yule; R C Greer; M Saunders; B Cameron; L E Boulware

doi:10.1016/j.cct.2018.09.004

Putting patients at the center of kidney care transitions: PREPARE NOW, a cluster randomized controlled trial

Contemp Clin Trials. 2018 Oct:73:98-110. doi: 10.1016/j.cct.2018.09.004. Epub 2018 Sep 12.

Authors

J A Green¹, P L Ephraim², F F Hill-Briggs³, T Browne⁴, T S Strigo⁵, C L Hauer⁶, R A Stametz⁷, J D Darer⁸, U D Patel⁹, K Lang-Lindsey¹⁰, B L Bankes¹¹, S A Bolden¹², P Danielson¹³, S Ruff¹⁴, L Schmidt¹⁵, A Swoboda¹⁶, P Woods¹⁷, B Vinson¹⁸, D Littlewood¹⁹, G Jackson²⁰, J F Pendergast²¹, J St Clair Russell²², K Collins²³, E Norfolk²⁴, I D Bucaloiu²⁵, S Kethireddy²⁶, C Collins²⁷, D Davis²⁸, J dePrisco²⁹, D Malloy³⁰, C J Diamantidis³¹, S Fulmer³², J Martin³³, D Schatell³⁴, N Tangri³⁵, A Sees³⁶, C Siegrist³⁷, J Breed Jr³⁸, A Medley³⁹, E Graboski⁴⁰, J Billet⁴¹, M Hackenberg⁴², D Singer⁴³, S Stewart⁴⁴, A Alkon⁴⁵, N A Bhavsar⁴⁶, L Lewis-Boyer⁴⁷, C Martz⁴⁸, C Yule⁴⁹, R C Greer⁵⁰, M Saunders⁵¹, B Cameron⁵², L E Boulware⁵³

Affiliations

¹ Department of Nephrology, Geisinger Commonwealth School of Medicine, Danville, PA, USA; Kidney Health Research Institute, Geisinger, Danville, PA, USA. Electronic address: [email protected].
² Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, MD, USA. Electronic address: [email protected].
³ Division of General Internal Medicine, Johns Hopkins University, Baltimore, MD, USA. Electronic address: [email protected].
⁴ College of Social Work, University of South Carolina, Columbia, SC, USA. Electronic address: [email protected].
⁵ Division of General Internal Medicine, Duke University School of Medicine, Durham, NC, USA. Electronic address: [email protected].
⁶ Center for Clinical Innovation, Institute for Advanced Application, Geisinger, Danville, PA, USA. Electronic address: [email protected].
⁷ Center for Clinical Innovation, Institute for Advanced Application, Geisinger, Danville, PA, USA. Electronic address: [email protected].
⁸ Decision Support Siemens Healthineers Malvern, PA, USA. Electronic address: [email protected].
⁹ Division of Nephrology, Duke University School of Medicine, Durham, NC, USA; Gilead Sciences, Inc., Foster City, CA, USA. Electronic address: [email protected].
¹⁰ Department of Social Work, Alabama State University, Montgomery, AL, USA. Electronic address: [email protected].
¹¹ Patient stakeholder co-author, Bloomsburg, PA, USA.
¹² Patient stakeholder co-author, Jacksonville, FL, USA.
¹³ Patient stakeholder co-author, Portland, OR, USA.
¹⁴ Patient stakeholder co-author, Mooresville, NC, USA.
¹⁵ Patient stakeholder co-author, Liberty, Illinois, USA.
¹⁶ Patient stakeholder co-author, Edgewater, MD, USA.
¹⁷ Patient stakeholder co-author, Hartsdale, New York, NY, USA.
¹⁸ Quality Insights Renal Network 5, Richmond, VA, USA. Electronic address: [email protected].
¹⁹ The Care Centered Collaborative, Pennsylvania Medical Society, Harrisburg, PA, USA. Electronic address: [email protected].
²⁰ Division of General Internal Medicine, Duke University School of Medicine, Durham, NC, USA. Electronic address: [email protected].
²¹ Department of Biostatistics & Bioinformatics, Duke University School of Medicine, Durham, NC, USA. Electronic address: [email protected].
²² Division of General Internal Medicine, Duke University School of Medicine, Durham, NC, USA. Electronic address: [email protected].
²³ Patient Services, National Kidney Foundation, New York, NY, USA. Electronic address: [email protected].
²⁴ Department of Nephrology, Geisinger Commonwealth School of Medicine, Danville, PA, USA. Electronic address: [email protected].
²⁵ Department of Nephrology, Geisinger Medical Center, Danville, PA, USA. Electronic address: [email protected].
²⁶ Critical Care Medicine, Northeast Georgia Health System, Gainesville, GA, USA.
²⁷ Adult Psychology and Behavioral Medicine, Department of Psychiatry, Geisinger, Danville, PA, USA. Electronic address: [email protected].
²⁸ Center for Translational Bioethics and Health Care Policy, Geisinger, Danville, PA, USA. Electronic address: [email protected].
²⁹ Center for Clinical Innovation, Institute for Advanced Application, Geisinger, Danville, PA, USA. Electronic address: [email protected].
³⁰ Center for Clinical Innovation, Institute for Advanced Application, Geisinger, Danville, PA, USA. Electronic address: [email protected].
³¹ Division of General Internal Medicine, Duke University School of Medicine, Durham, NC, USA; Division of Nephrology, Duke University School of Medicine, Durham, NC, USA. Electronic address: [email protected].
³² Geisinger Health Plan, Danville, PA, USA. Electronic address: [email protected].
³³ Program Development, National Kidney Foundation, New York, NY, USA. Electronic address: [email protected].
³⁴ Medical Education Institute, Madison, WI, USA. Electronic address: [email protected].
³⁵ Department of Medicine, Section of Nephrology, University of Manitoba, 66 Chancellors Cir, Winnipeg, MB R3T 2N2, Canada; Chronic Disease Innovation Center, Seven Oaks General Hospital, 2300 Mcphillips St, Winnipeg, MB R2V 3M3, Canada. Electronic address: [email protected].
³⁶ Anthem, Inc., Indianapolis, IN, USA.
³⁷ Center for Clinical Innovation, Institute for Advanced Application, Geisinger, Danville, PA, USA. Electronic address: [email protected].
³⁸ Center for Clinical Innovation, Institute for Advanced Application, Geisinger, Danville, PA, USA. Electronic address: [email protected].
³⁹ Geisinger Health Plan, Danville, PA, USA. Electronic address: [email protected].
⁴⁰ Kidney Health Research Institute, Geisinger, Danville, PA, USA. Electronic address: [email protected].
⁴¹ Center for Clinical Innovation, Institute for Advanced Application, Geisinger, Danville, PA, USA. Electronic address: [email protected].
⁴² Center for Clinical Innovation, Institute for Advanced Application, Geisinger, Danville, PA, USA. Electronic address: [email protected].
⁴³ Renal Physicians Association, Rockville, MD, USA. Electronic address: [email protected].
⁴⁴ Council of Nephrology Social Workers, National Kidney Foundation, New York, NY, USA. Electronic address: [email protected].
⁴⁵ Division of General Internal Medicine, Duke University School of Medicine, Durham, NC, USA. Electronic address: [email protected].
⁴⁶ Division of General Internal Medicine, Duke University School of Medicine, Durham, NC, USA. Electronic address: [email protected].
⁴⁷ Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, MD, USA; Division of General Internal Medicine, Johns Hopkins University, Baltimore, MD, USA. Electronic address: [email protected].
⁴⁸ Geisinger Health Plan, Danville, PA, USA. Electronic address: [email protected].
⁴⁹ Kidney Health Research Institute, Geisinger, Danville, PA, USA. Electronic address: [email protected].
⁵⁰ Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, MD, USA; Division of General Internal Medicine, Johns Hopkins University, Baltimore, MD, USA. Electronic address: [email protected].
⁵¹ Section of General Internal Medicine, Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA. Electronic address: [email protected].
⁵² Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA. Electronic address: [email protected].
⁵³ Division of General Internal Medicine, Duke University School of Medicine, Durham, NC, USA. Electronic address: [email protected].

Abstract

Care for patients transitioning from chronic kidney disease to kidney failure often falls short of meeting patients' needs. The PREPARE NOW study is a cluster randomized controlled trial studying the effectiveness of a pragmatic health system intervention, 'Patient Centered Kidney Transition Care,' a multi-component health system intervention designed to improve patients' preparation for kidney failure treatment. Patient-Centered Kidney Transition Care provides a suite of new electronic health information tools (including a disease registry and risk prediction tools) to help providers recognize patients in need of Kidney Transitions Care and focus their attention on patients' values and treatment preferences. Patient-Centered Kidney Transition Care also adds a 'Kidney Transitions Specialist' to the nephrology health care team to facilitate patients' self-management empowerment, shared-decision making, psychosocial support, care navigation, and health care team communication. The PREPARE NOW study is conducted among eight [8] outpatient nephrology clinics at Geisinger, a large integrated health system in rural Pennsylvania. Four randomly selected nephrology clinics employ the Patient Centered Kidney Transitions Care intervention while four clinics employ usual nephrology care. To assess intervention effectiveness, patient reported, biomedical, and health system outcomes are collected annually over a period of 36 months via telephone questionnaires and electronic health records. The PREPARE NOW Study may provide needed evidence on the effectiveness of patient-centered health system interventions to improve nephrology patients' experiences, capabilities, and clinical outcomes, and it will guide the implementation of similar interventions elsewhere.

Trial registration: NCT02722382.

Keywords: Care navigation; Chronic kidney disease; Electronic health tools; Kidney failure; Self-management; Shared decision-making.

Publication types

Clinical Trial Protocol
Research Support, Non-U.S. Gov't

MeSH terms

Decision Making
Delivery of Health Care
Disease Progression
Kidney Failure, Chronic* / therapy
Multicenter Studies as Topic
Nephrology
Patient Care Team
Patient Navigation
Patient Reported Outcome Measures
Patient Transfer*
Patient-Centered Care*
Pragmatic Clinical Trials as Topic
Registries
Renal Insufficiency, Chronic* / therapy
Self-Management
Social Support

Associated data

ClinicalTrials.gov/NCT02722382

Grants and funding

K01 HL140146/HL/NHLBI NIH HHS/United States