# Pilot Testing of a Communication Intervention to Promote Shared Dialysis Decision Making in Older Patients with Chronic Kidney Disease (DIAL-SDM Trial)

> **NIH NIH K23** · UNIVERSITY OF ROCHESTER · 2020 · $194,252

## Abstract

Brief Summary
Older patients ≥65 years with chronic kidney disease (CKD) face challenges in decision making around dialysis
initiation. These patients report little effort by physicians to elicit treatment preferences, discuss prognoses or
explain the burdens/benefits of dialysis options including conservative management. Older patients with CKD
often prefer maintaining the quality of life over prolonging life, and many regret their decision to start dialysis:
nearly one quarter withdraw from dialysis each year. Shared dialysis decision-making requires active
engagement between nephrologists and patients to align patient, caregiver and physician communication around
common goals. The proposed study is a pilot randomized cluster pragmatic trial of a shared dialysis decision-
making (DIAL-SDM) intervention for nephrologists (n=20) and their patients ≥65 years old (n=60) with an
estimated glomerular filtration rate (eGFR) of ≤ 20 ml/min/ /1.73 m2. Nephrologists in the Intervention Group will
receive 3 remote online communication training sessions, delivered by a standardized patient instructor (SPI)
via Zoom technology who will enact clinical scenarios and offer feedback. In parallel, patients (and caregivers, if
available) will receive 2 coaching sessions provided by a health coach, who will explore each patient's relevant
contextual information (values, preferences, and goals), and help them identify and practice important questions
for their nephrologist. Nephrologists in the Control Group will provide their patients with usual care. The study
outcomes will be assessed during two nephrology office visits and at 6 months.
Specifically, we aim to:
Aim 1 (primary): Assess the feasibility, acceptability, and fidelity of the DIAL-SDM intervention.
Aim 2 (secondary): Test the preliminary effectiveness of the intervention on (a) active patient participation in
dialysis decision-making, as measured by the Active Patient Participation Coding scores from audio-recordings
of office visits; (b) shared dialysis decision-making, as measured by OPTION scale scores from audio-recordings
of the office visits, and patient-reported Shared Decision-Making Questionnaire; (c) patients' initial choice of
dialysis options (home vs. in-center dialysis vs. conservative management).

## Key facts

- **NIH application ID:** 9976804
- **Project number:** 1K23DK121939-01A1
- **Recipient organization:** UNIVERSITY OF ROCHESTER
- **Principal Investigator:** Fahad Saeed
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $194,252
- **Award type:** 1
- **Project period:** 2020-07-01 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9976804

## Citation

> US National Institutes of Health, RePORTER application 9976804, Pilot Testing of a Communication Intervention to Promote Shared Dialysis Decision Making in Older Patients with Chronic Kidney Disease (DIAL-SDM Trial) (1K23DK121939-01A1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9976804. Licensed CC0.

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