# Integration of Geriatric Care into Dialysis Clinics

> **NIH NIH R01** · DUKE UNIVERSITY · 2024 · $780,601

## Abstract

PROJECT SUMMARY/ABSTRACT
Older dialysis patients commonly have geriatric syndromes which contribute to increased healthcare utilization
and poor quality of life. Currently, identification and management of geriatric syndromes are not included in
dialysis care. Adding geriatric syndrome management into routine care for dialysis patients could result in
significant improvements in quality of life and healthcare utilization. Barriers to integration of geriatric evaluation
and management into dialysis clinics (e.g., time, personnel, costs) can be minimized through the development
of innovative geriatric care models that leverage the existing dialysis unit interprofessional team and workflow.
We will pilot a new dialysis care model that includes a centralized geriatric team that uses information from the
Geriatric screen for OLder Dialysis patients (GOLD) to develop individualized recommendations for geriatric
syndrome management based on the patient’s priorities. The GOLD is a self-administered screening battery of
validated instruments to screen for a range of geriatric syndromes (cognitive impairment, depression, falls,
mobility disability, social support needs, and malnutrition). The multidisciplinary dialysis team will integrate the
recommendations into their care plans with support from the centralized geriatric team. Ultimately, this geriatric
care model could be seamlessly integrated into dialysis clinic structure. The objective of this application is to
optimize the care model with key stakeholder input and conduct a pilot randomized controlled trial (RCT) to
obtain evidence critical to inform a definitive RCT. We propose three aims: 1) iteratively refine GOLD to achieve
acceptable agreement with a geriatrician evaluation, 2) iteratively refine the geriatric care model to ensure
acceptability and feasibility to key stakeholders, and 3) conduct a pilot RCT (n=100) to evaluate the geriatric care
model’s impact on geriatric syndrome management and inform design of a larger RCT. For Aim 1, we will have
participants complete the GOLD and undergo geriatric evaluation. We will assess agreement of each GOLD
instrument with its corresponding geriatric evaluation, and if target agreement is not achieved, we will iteratively
modify and re-test the GOLD instrument. For Aim 2, we will refine the care model using experience-based co-
design with a stakeholder advisory board and multiple phases of feedback from study participants. After patients
complete the care model, these patients and their dialysis clinicians will assess acceptability and feasibility of
the care model through surveys and interviews. The care model will be iteratively refined until specific metrics of
success are achieved. For Aim 3, patients will be randomized to receive the geriatric care model or usual care;
geriatric syndrome management measured by patient report and chart abstraction will be compared at 3 months.
We will also assess patient reported outcomes, physical function, and...

## Key facts

- **NIH application ID:** 10916235
- **Project number:** 5R01AG076918-02
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** Rasheeda K Hall
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $780,601
- **Award type:** 5
- **Project period:** 2023-09-01 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10916235

## Citation

> US National Institutes of Health, RePORTER application 10916235, Integration of Geriatric Care into Dialysis Clinics (5R01AG076918-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10916235. Licensed CC0.

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