ArticleKidney international reports2026
Evaluation of a Decision Aid in Kidney Care Counseling for Older Adults.
Article in Kidney international reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
7 authors.
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Abstract
Introduction: We evaluated the effectiveness of a web-based patient decision aid (PDA) developed for older adults with end-stage kidney disease (ESKD) and their caregivers, integrated into kidney care counseling. Methods: A pragmatic pre- and post-trial with a comparison group was conducted in Singapore with patients aged ≥ 70 years with ESKD and their caregivers. Usual care participants received standard counseling, whereas intervention arm received counseling using the PDA. The primary outcome was change in decisional conflict from pre- to post-counseling between arms. Secondary outcomes were conservative management (CM) awareness, stated treatment preference at postcounseling, and real-life treatment choice at 6 months. Analyses used a generalized linear mixed model for the primary outcome and logistic regressions for secondary outcomes. Results: A total of 143 participants were enrolled (75 patients and 68 caregivers). Caregivers in the intervention arm experienced significantly greater reductions in decisional conflict compared with usual care (β = -4.48; Conclusion: Although future studies are needed to confirm these results, this study provides preliminary, suggestive evidence that integrating a web-based PDA into kidney care counseling may reduce caregiver decisional conflict, improve patient awareness of CM, and shift both stated and actual treatment choices away from dialysis.
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