Intensive Patient Referral and Education Program Prior to Renal Replacement Therapy

NCT ID: NCT06397456

Last Updated: 2025-11-14

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

180 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-09-04

Study Completion Date

2026-06-30

Brief Summary

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Intensive Patient Referral and Education Program prior to Renal Replacement Therapy (iPREP-RRT) is a 12-week intervention that identifies hospitalized African Americans with advanced chronic kidney disease (CKD) and provides them with hospital- and community-based education, navigation and self-management support. Participants will be randomized to the iPREP-RRT intervention versus enhanced usual care.

Detailed Description

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The Intensive Patient Referral and Education Program prior to Renal Replacement Therapy (iPREP-RRT) will determine the efficacy of the hospital-based patient intervention (HPI) in improving patient knowledge, self-efficacy, and intent for chronic kidney disease (CKD) self-management and renal replacement therapy (RRT) planning; and 2) determine the efficacy of the community-based patient intervention (CPI) during a 12 week outpatient follow-up program that combines outpatient follow-up with multiple modes of communication (in-person session, phone calls and personalized text messaging) and navigation in increasing participants' initiation and maintenance of CKD self-management and RRT planning, compared to enhanced usual care (attention controls).

The goal is to improve knowledge and outcomes for African American patients with advanced CKD through the iPREP-RRT. To accomplish this goal, investigators will 1) determine the efficacy of the hospital-based patient intervention (HPI) in improving participant knowledge, self-efficacy, and intent for CKD self-management and RRT planning; and 2) determine the efficacy of the community-based patient intervention (CPI) during a 12 week outpatient program that combines outpatient follow-up with multiple modes of communication (in-person session, phone calls and personalized text messaging) and navigation in increasing initiation and maintenance of CKD self-management and RRT planning, compared to enhanced usual care. To that end, investigators will conduct a one-site randomized controlled trial, where participants will be randomized in a 1:1 ratio into either the intervention (iPREP-RRT) or control groups (enhanced usual care). The randomization will be stratified by baseline blood pressure (controlled or uncontrolled). Participants will receive 2 in-person education sessions (during hospitalization and week 12), phone sessions at weeks 4 and 8, and weekly personalized text message contact. The duration of the intervention will be 12 weeks, and participants and controls will be assessed pre-intervention, immediately post-hospital based intervention, at 4 ,8 and 12 weeks during community-based intervention and 4 weeks post-intervention (16 weeks).

Conditions

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Chronic Kidney Disease Hypertension

Keywords

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Hospitalized Patients African American Motivational Interviewing

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

DOUBLE

Caregivers Outcome Assessors
The care provider will not be involved in the enrollment or assessment process. The outcomes assessor will analyze the outcomes without knowledge of allocation.

Study Groups

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Intensive Intervention (iPREP RRT)

The intervention is administered by a patient educator (PE), a culturally concordant health educator. S/he will review the CKD and RRT education materials on a tablet device with the participant, answer any questions they have, and using motivational interviewing techniques get a commitment for future action. The participant and the patient educator will work together to decide on potential CKD self-management and RRT options and/or next steps. The PE will teach the participant how to use the home blood pressure monitor and will leave it with the participant.

The patient educator will check in with the participant through text messages and follow-up phone calls.

Group Type EXPERIMENTAL

Commitment to Change

Intervention Type BEHAVIORAL

Motivational interviewing to assist participants in committing to change in CKD management or RRT selection.

Blood pressure monitoring

Intervention Type BEHAVIORAL

Participants will learn how to check their blood pressure and will receive a blood pressure cuff for home.

Text-based reinforcement for CKD self-management

Intervention Type BEHAVIORAL

Patient educator will use text messages based on social cognitive theory to remind participants about and reinforce goals set around CKD self-management, blood pressure control and RRT selection

Community-based education session, reinforcement for self-management

Intervention Type BEHAVIORAL

Patient educator will use provide a "booster" session based on social cognitive theory to remind participants about and reinforce goals set around CKD self-management, blood pressure control and RRT selection

In-Person Patient Education

Intervention Type BEHAVIORAL

In-person patient education about CKD, CKD risk factor management and renal replacement therapy options.

Enhanced Usual Care

The enhanced usual care is administered by a patient educator (PE), a culturally concordant health educator. The PE will drop off written general health education materials.

The patient educator will check in with the participant through text messages.

Group Type PLACEBO_COMPARATOR

Written Patient Education

Intervention Type BEHAVIORAL

Written patient education booklet about general health care management including taking medications, having a primary care doctor, weight management and exercise.

Text-based reinforcement for general health self-management

Intervention Type BEHAVIORAL

Patient educator will use text messages to send general health management messages

Interventions

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Commitment to Change

Motivational interviewing to assist participants in committing to change in CKD management or RRT selection.

Intervention Type BEHAVIORAL

Blood pressure monitoring

Participants will learn how to check their blood pressure and will receive a blood pressure cuff for home.

Intervention Type BEHAVIORAL

Written Patient Education

Written patient education booklet about general health care management including taking medications, having a primary care doctor, weight management and exercise.

Intervention Type BEHAVIORAL

Text-based reinforcement for CKD self-management

Patient educator will use text messages based on social cognitive theory to remind participants about and reinforce goals set around CKD self-management, blood pressure control and RRT selection

Intervention Type BEHAVIORAL

Community-based education session, reinforcement for self-management

Patient educator will use provide a "booster" session based on social cognitive theory to remind participants about and reinforce goals set around CKD self-management, blood pressure control and RRT selection

Intervention Type BEHAVIORAL

Text-based reinforcement for general health self-management

Patient educator will use text messages to send general health management messages

Intervention Type BEHAVIORAL

In-Person Patient Education

In-person patient education about CKD, CKD risk factor management and renal replacement therapy options.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Patients over the age of 18 and under 70
* Admitted to the University of Chicago inpatient general medicine service
* Likely hospital stay greater than 48 hours
* Diagnosis of advanced CKD (Stage 3B or above, as determine by problem list, ICD- 10 codes or eGFR\<45 during admission and from previous medical encounters)
* Self-identify as Black or African American

Exclusion Criteria

* Non-English speaking
* Unable to communicate due to current medical status
* Unable to consent due to mental status
* Expected hospital stay less than 24 hour
* Current admission in ICU
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

NIH

Sponsor Role collaborator

University of Chicago

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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University of Chicago Medical Center

Chicago, Illinois, United States

Site Status RECRUITING

Countries

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United States

Facility Contacts

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Milda Saunders, MD

Role: primary

Akilah King, MSW

Role: backup

Other Identifiers

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R01DK124597

Identifier Type: NIH

Identifier Source: secondary_id

View Link

IRB20-1663

Identifier Type: -

Identifier Source: org_study_id