scholarly journals Case-control study of end-of-life treatment preferences and costs following advance care planning for adults with end-stage kidney disease

Nephrology ◽  
2019 ◽  
Vol 24 (2) ◽  
pp. 148-154 ◽  
Author(s):  
Marcus Sellars ◽  
Rachael L Morton ◽  
Josephine M Clayton ◽  
Allison Tong ◽  
Daveena Mawren ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Advance Care Planning ◽  
Case Control Study ◽  
Case Control ◽  
Treatment Preferences ◽  
Care Planning ◽  
End Stage Kidney Disease ◽  
Advance Care ◽  
End Stage ◽  
Control Study

scholarly journals Advance Care Planning With Patients Who Have End-Stage Kidney Disease: A Systematic Realist Review

2018 ◽  
Vol 56 (5) ◽  
pp. 795-807.e18 ◽  
Author(s):  
Peter O'Halloran ◽  
Helen Noble ◽  
Kelly Norwood ◽  
Peter Maxwell ◽  
Joanne Shields ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Advance Care Planning ◽  
Realist Review ◽  
Care Planning ◽  
End Stage Kidney Disease ◽  
Advance Care ◽  
End Stage

scholarly journals Costs and outcomes of advance care planning and end-of-life care for older adults with end-stage kidney disease: A person-centred decision analysis

PLoS ONE ◽  
2019 ◽  
Vol 14 (5) ◽  
pp. e0217787 ◽  
Author(s):  
Marcus Sellars ◽  
Josephine M. Clayton ◽  
Karen M. Detering ◽  
Allison Tong ◽  
David Power ◽  
...  
Keyword(s):  
Older Adults ◽  
Kidney Disease ◽  
Decision Analysis ◽  
Advance Care Planning ◽  
End Of Life Care ◽  
Care Planning ◽  
Life Care ◽  
End Stage Kidney Disease ◽  
Advance Care ◽  
End Stage

Advance Care Planning to Elicit and Respect Patient Values and Preferences

2020 ◽  
pp. 98-107
Author(s):  
Jean L. Holley ◽  
J. April Yasunaga
Keyword(s):  
Kidney Disease ◽  
Advance Directives ◽  
Advance Care Planning ◽  
Care Planning ◽  
Power Of Attorney ◽  
End Stage Kidney Disease ◽  
Health States ◽  
Advance Care ◽  
Patient Values ◽  
End Stage

Advance care planning (ACP) is a patient-centered process to elicit patient and family goals and values that shape medical decision-making and form the basis for completing written advance directives. Advance directives such as healthcare power of attorney, surrogate decision-maker identification, and living wills are executed by the patient. These may be supplemented by provider orders such as resuscitation status (do not resuscitate/do not attempt resuscitation) and provider orders for life-sustaining treatment. Provider input into ACP is required as patients and families need information on prognosis and risks and benefits of interventions to make informed decisions. Because health states influence decisions for ongoing care, ACP is a process that requires revisiting wishes and goals via discussions at stages throughout a patient’s life. All healthcare systems through which a patient passes will need to be involved and cognizant of advance directives to ensure a patient’s wishes are honored. Dialysis units are an integral part of the healthcare system for end-stage kidney disease patients and need to be engaged in the ACP process. Consensus statements, guidelines, and tools exist to facilitate ACP in end-stage kidney disease and chronic kidney disease patients.

scholarly journals Nurse-led advance care planning with older people who have end-stage kidney disease: feasibility of a deferred entry randomised controlled trial incorporating an economic evaluation and mixed methods process evaluation (ACReDiT)

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Peter O’Halloran ◽  
Helen Noble ◽  
Kelly Norwood ◽  
Peter Maxwell ◽  
Fliss Murtagh ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Data Collection ◽  
Advance Care Planning ◽  
Care Plan ◽  
Care Planning ◽  
End Stage Kidney Disease ◽  
Advance Care Plan ◽  
Advance Care ◽  
Randomised Controlled ◽  
End Stage

Abstract Background Advance Care Planning is recommended for people with end-stage kidney disease but evidence is limited. Robust clinical trials are needed to investigate the impact of advance care planning in this population. There is little available data on cost-effectiveness to guide decision makers in allocating resources for advance care planning. Therefore we sought to determine the feasibility of a randomised controlled trial and to test methods for assessing cost-effectiveness. Methods A deferred entry, randomised controlled feasibility trial, incorporating economic and process evaluations, with people with end-stage kidney disease, aged 65 years or older, receiving haemodialysis, in two renal haemodialysis units in Northern Ireland, UK. A nurse facilitator helped the patient make an advance care plan identifying: a surrogate decision-maker; what the participant would like to happen in the future; any advance decision to refuse treatment; preferred place of care at end-of-life. Results Recruitment lasted 189 days; intervention and data collection 443 days. Of the 67 patients invited to participate 30 (45%) declined and 36 were randomised to immediate or deferred advance care plan groups. Twenty-two (61%) made an advance care plan and completed data collection at 12 weeks; 17 (47.2%) were able to identify a surrogate willing to be named in the advance care plan document. The intervention was well-received and encouraged end-of-life conversations, but did not succeed in helping patients to fully clarify their values or consider specific treatment choices. There was no significant difference in health system costs between the immediate and deferred groups. Conclusions A trial of advance care planning with participants receiving haemodialysis is feasible and acceptable to patients, but challenging. A full trial would require a pool of potential participants five times larger than the number required to complete data collection at 3 months. Widening eligibility criteria to include younger (under 65 years of age) and less frail patients, together with special efforts to engage and retain surrogates may improve recruitment and retention. Traditional advance care planning outcomes may need to be supplemented with those that are defined by patients, helping them to participate with clinicians in making medical decisions. Trial registration Registered December 16, 2015. ClinicalTrials.gov Identifier: NCT02631200.

Advance care planning for end-stage kidney disease

2013 ◽  
Author(s):  
Andem Effiong ◽  
Laura Shinn ◽  
Thaddeus M Pope ◽  
Joseph A Raho
Keyword(s):  
Kidney Disease ◽  
Advance Care Planning ◽  
Care Planning ◽  
End Stage Kidney Disease ◽  
Advance Care ◽  
End Stage
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