The Choice of Renal Replacement Therapy (CORETH) project: study design and methods

Abstract

BackgroundTo date, research has neglected the patient's psychosocial and cognitive conditions as contributing factors to dialysis modality decision-making. Hence, the Choice of Renal Replacement Therapy (CORETH) study aims to examine these conditions with regard to their impact on the choice. Here we describe the design of the multicentre study, which is supported by a grant from the German Ministry for Education and Research.MethodsTwo groups of patients will be compared after having chosen peritoneal or haemodialysis as permanent treatment. About 1200 participants from 50 dialysis centres all over Germany will be questioned. The questionnaire addresses social, psychological and shared decision-making aspects. Furthermore, cognitive functioning will be tested. For an economic evaluation direct and indirect costs of treatment will be calculated. Changes will be examined through a one-year follow-up.ConclusionsThe results will enlighten the treatment choice under the German healthcare system. They will provide further insight regarding the discussion on patient autonomy. From the patients' perspective, the results will help to strengthen their participation in the individual process of health-related decision-making.

Cognitive Testing in Patients with CKD: The Problem of Missing Cases

“…There were no significant differences with respect to the distribution of sex or duration of therapy. Furthermore, patients with missing CT data and patients with full CT data were compared regarding physical and psychosocial metrics from the CORETH Project (19). The comparison showed that patients with missing CT data were more comorbid; indicated a lower physical quality of life; lived more closely to the dialysis unit; had a smaller living space, a smaller social network, and fewer persons living in the same household; were less participation oriented; experienced poorer shared decision making; and were more likely to have depression ( Table 3).…”

“…The project addresses the decision making for either HD or PD focusing on the perspectives of recently initiated patients on dialysis. Detailed information about the study design has been already published (16,19,20). Patients were recruited from May of 2014 to May of 2015 from 55 dialysis units all over Germany.…”

“…We analyzed the reasons for nonfeasibility of CT and the characteristics of patients with missing CT data. Therefore, relevant CORETH metrics were used (the study protocol [19] has detailed description and referencing). Mean values (Ms) and SDs were calculated for the subsamples regarding continuous variables.…”

“…This may be somewhat difficult for an article focusing on a missing analysis on the first view. However, it should be kept in mind that we derived CT data from the CORETH Project, which is, in turn, the only up to date multicenter study on psychosocial and neurocognitive factors in the early phase of dialysis throughout Germany with a comparably large patient-centered data pool (16,19,20). Almost all missing data were in the d2-R score, whereas no data were missing in the KDQoL-SF cognition subscale.…”

Erfassung sozialer Ressourcen bei chronisch Kranken: Entwicklung und erste psychometrische Überprüfung eines egozentrierten Netzwerkgenerators

“…auch elektronisch anwend-und auswertbar (Handy, Computer). Darüber hinaus ist er in verschiedenen Settings des Versorgungsgeschehens einsetzbar und wird derzeit auch in einer weiteren multizentrischen Studie bei Patienten mit endgradigem Organversagen eingesetzt[27].Wir bedanken uns bei allenRehabilitanden für ihre Teilnahme. Des Weiteren möchten wir folgenden Kliniken für Ihre Expertise und Unterstützung danken: Eisenmoorbad Bad Schmiedeberg, Median-Klinik Kalbe/Milde, Paracelsus Klinik Am See-Bad Gandersheim, Paracelsus Klinik Bad Suderode, Teufelsbad Klinik Blankenburg, Waldburg-Zeil Klinik Bad Salzelmen, Gesundheitspark Bad Gottleuba, Rehabilitationsklinik an der Salza, Median-Klinik Bad Lobenstein, Fachklinikum Brandis, Rehabilitationsklinik Göhren, Rehabilitationsklinik Dahlener Heide.…”