Video decision aid increases advance care planning in seniors with chronic kidney disease
· Medical Xpressby Elana Gotkine
edited by Sadie Harley, reviewed by Andrew Zinin
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Among older adults with advanced chronic kidney disease (CKD), a video decision aid increases advance care planning (ACP) documentation in the electronic health record, according to a study published in JAMA Internal Medicine to coincide with Kidney Week, the annual meeting of the American Society of Nephrology, held from Oct. 21 to 25 in Denver.
Angelo E. Volandes, M.D., from Dartmouth Health in Lebanon, New Hampshire, and colleagues conducted a multicenter, parallel-group, randomized clinical trial at 12 ambulatory clinics to examine whether a video decision aid about treatment options for advanced CKD, combined with patient-created video declarations, increases ACP documentation among adults aged 65 years and older with advanced CKD.
While 225 control participants received usual medical care, 228 intervention participants viewed a certified video decision aid depicting three treatment options for advanced CKD and then created a video declaration stating their goals, values, and treatment preferences, which was sent to their treating clinician.
The researchers found that ACP documentation was higher in the intervention group than the control group at 12 months (56.6% versus 40.0%), as was documented discussion of treatment options for kidney failure (46.1% versus 31.6%). After viewing the video, fewer intervention participants than control participants were undecided about treatment (13.2% versus 41.3%) and more preferred conservative kidney management (50.7% versus 31.8%).
"While further research is needed to determine whether increased documentation translates into goal-concordant care, these findings suggest that standardized education paired with patient-authored statements of preferences is a feasible addition to routine CKD care," the authors write.
Publication details
Angelo E. Volandes et al., Video Decision Support and Advance Care Planning in Older Adults With Advanced Kidney Disease, JAMA Internal Medicine (2026). DOI: 10.1001/jamainternmed.2026.5989
Journal information: JAMA Internal Medicine
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