We are proud to show off the work of Nicole DePasquale, PhD, an Assistant Professor in Duke General Internal Medicine. Dr. DePasquale is the lead investigator on a study entitled Self-management in older adults with chronic kidney disease: Help from family care partners and its relationship with patients’ psychological and health-related well-being.
Project Summary
Background/Rationale
Chronic kidney disease (CKD) is a progressive, life-altering condition characterized by disproportionate prevalence, substantial physical and psychosocial challenges, increased health care costs, and elevated family strain and burden among older adults. Because older adults often require support from family care partners to self-manage chronic disease, it is critical to acquire an understanding of how to best support older adults and their family care partners as they work together to manage the full course of CKD. Yet, the family care partners of patients with CKD are seldom a focal point in research and in practice. The highlighted research represents the first of three studies that will leverage existing resources, multi-method approaches, and novel data collection to examine ways in which older adult-family care partner dyads manage CKD together and the impact dyadic management has on their health as individuals and as a whole.
Objective
Quantify associations between care partner help with CKD self-management and patient CKD self-management self-efficacy, depression, and health-related quality of life (HR-QOL) over time.
Hypothesis
More care partner help with CKD self-management is associated with improvements in patient CKD self-management self-efficacy, depression, and HR-QOL over time.
Study Design and Participants
This longitudinal analysis will be conducted using data from the PREPARE NOW study (PI: Boulware), a PCORI-funded, 4-year randomized controlled trial testing the effectiveness of a health system intervention to improve shared and informed decision-making for advanced CKD patients. The trial occurred within the Geisinger Health System (GHS), where clinical practice sites provide outpatient nephrology care to approximately 4,000 CKD patients. Between April 2016 and March 2017, individuals were eligible for the trial if they were English-speaking, older than 18 years of age, had seen a nephrologist at a GHS site within the previous year, met the Kidney Disease Improving Global Outcomes (KDIGO) guidelines for advanced CKD (i.e., those with stage G3aA3, G3bA2-A3, G4A1-A3, and G5A1-A3 based on eGFR and albuminuria), and had not started treatment. Study participants completed a standard telephone questionnaire administered by trained research staff; they also provided consent to obtain their electronic health records. All participants who were > 65 years of age, had not started dialysis at the time of survey administration, and had completed 2 or more annual survey waves were eligible for the present study (n = 504).
Team
Principal Investigator: Nicole DePasquale,PhD
Mentor: L. Ebony Boulware, MD
Statisticians: Sarah Peskoe, Sarah Morton, Jane Pendergast