The WISHED Trial: implementation of an interactive health communication application for patients with chronic kidney disease.
BACKGROUND
Despite many advantages over facility-based therapies, less than 25 % of prevalent dialysis patients in Ontario are on a home therapy. Interactive health communication applications, web-based packages for patients, have been shown to have a beneficial effect on knowledge, social support, self-efficacy, and behavioral and clinical outcomes but have not been evaluated in patients with chronic kidney disease (CKD). Web-based tools designed for patients with CKD exist but to our knowledge have not been assessed in their ability to influence dialysis modality decision-making.


OBJECTIVE
To determine if a web-based tool increases utilization of a home-based therapy in patients with CKD starting dialysis.


METHODS
This is a multi-centered randomized controlled study.


METHODS
Participants will be recruited from sites in Canada.


METHODS
Two hundred and sixty-four consenting patients with an estimated glomerular filtration rate (eGFR) less than 20 ml/min/1.73 m(2) who have received modality education will be enrolled in the study.


METHODS
The primary outcome will be the proportion of participants who are on dialysis using a home-based therapy within 3 months of dialysis initiation. Secondary outcomes will include the proportion of patients intending to perform a home-based modality and measures of dialysis knowledge, decision conflict, and social support.


METHODS
The between-group differences in frequencies will be expressed as either absolute risk differences and/or by calculating the odds ratio and its associated 95 % confidence interval.


CONCLUSIONS
This study will assess whether access to a website dedicated to supporting and promoting home-based dialysis therapies will increase the proportion of patients with CKD who initiate a home-based dialysis therapy.


BACKGROUND
ClinicalTrials.gov #NCT01403454, registration date: July 21, 2011.
St. Michael's Hospital, Toronto, ON Canada.
Andrea
A
Harvey
Division of Nephrology, McMaster University, Hamilton, ON Canada.
Michael
M
Walsh
Division of Nephrology, University of Western Ontario, London, ON Canada.
Arsh K
AK
Jain
Division of Nephrology, McMaster University, Hamilton, ON Canada.
Eric
E
Bosch
Division of Nephrology, McMaster University, Hamilton, ON Canada.
Cathy
C
Moreau
Division of Nephrology, Queen's University, Kingston, ON Canada.
Jocelyn
J
Garland
McMaster University, 50 Charlton Ave. E, Hamilton, ON L8N 4A6 Canada.
K Scott
KS
Brimble
Hemodialysis; Home dialysis; Interactive health communication application; Internet; Peritoneal dialysis