TL;DR
Turn quiet afternoons into listening time
- Thousands of audiobooks, podcasts and originals
- Listen on your phone, tablet or Echo — also offline
- Cancel anytime
A randomized trial involving 453 adults aged 65 and older with advanced chronic kidney disease found that a video decision aid paired with patient-recorded statements was associated with more advance care planning documentation at 12 months. The study did not establish whether the additional documentation led to care that matched patients’ preferences.
A randomized clinical trial found that older adults with advanced chronic kidney disease had more advance care planning documentation in their medical records after using a video decision aid and recording their treatment preferences than patients receiving usual care. At 12 months, documentation was present for 56.6% of the intervention group, compared with 40.0% of the control group, according to results published in JAMA Internal Medicine.
The study included 453 adults aged 65 or older with advanced kidney disease at 12 ambulatory clinics. Researchers led by Angelo E. Volandes of Dartmouth Health randomly assigned 228 participants to the intervention and 225 to usual medical care. The trial was designed to test whether structured information, together with a way for patients to communicate their priorities, could increase planning recorded in the electronic health record.
Participants in the intervention group watched a certified video decision aid depicting three treatment options for advanced kidney disease. They then made a video statement describing their goals, values and treatment preferences; that declaration was sent to their treating clinician. The control group received usual care, rather than the video-and-recording process described in the study.
At 12 months, clinicians had documented discussions of kidney failure treatment options for 46.1% of intervention participants, versus 31.6% of controls. After viewing the video, 13.2% of intervention participants were undecided about treatment, compared with 41.3% of controls. Conservative kidney management was the preferred option for 50.7% of the intervention group and 31.8% of the control group. These figures describe recorded planning and stated preferences, not whether participants ultimately received a particular treatment.
More Preferences Reached the Medical Record
Advance care planning can help patients communicate what matters to them before they face difficult treatment decisions. For people with advanced kidney disease, the options described in the study include different approaches to care, and preferences may not be obvious to clinicians unless patients discuss them. The trial suggests that a video explaining options, followed by a patient-authored declaration, may help make those discussions and preferences more visible in routine records.
The practical result was an increase in documentation, not proof that care matched each person’s goals. A record of a discussion or preference is one step in planning; it does not by itself show that a treatment decision was made, communicated across care settings or followed later. The study authors said further research is needed to determine whether the increase in documentation translates into goal-concordant care.
Products Worth Considering
Therabody JetBoots PRO Plus Wireless LED 3-in-1 Compression Boots, Short (29 in Inseam)
Garmin Venu 3 Fitness Smartwatch, 45 mm, Black
Therabody JetBoots Prime Wireless Compression Boots (Short, Under 29-Inch Inseam)
As an affiliate, we earn on qualifying purchases.
How the Kidney Care Trial Worked
The study was a multicenter, parallel-group randomized trial conducted across 12 outpatient clinics. The intervention combined two components: a standardized video depicting treatment options and a video declaration created by the patient. Because the intervention bundled education with a direct statement of preferences, the reported results do not establish which component contributed more to the difference.
The findings were published in JAMA Internal Medicine in 2026 and reported in connection with the American Society of Nephrology’s Kidney Week meeting, held in Denver from October 21 to 25. The paper is titled “Video Decision Support and Advance Care Planning in Older Adults With Advanced Kidney Disease” and has DOI 10.1001/jamainternmed.2026.5989.
““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 study authors
Documentation Does Not Prove Care Matched
The reported results do not show whether patients received treatment consistent with their recorded preferences, or whether the intervention affected health outcomes, quality of life or later treatment decisions. The authors explicitly call for further research on whether increased documentation leads to care aligned with patients’ goals.
The source report also does not provide details on how long the video and declaration process took, whether participants kept their preferences up to date, or how the approach would work in clinics outside the 12 study sites. Since the intervention combined a video aid and a patient-created statement, the separate effect of each part is not established by the reported comparison.
Further Study of Care Outcomes
The next research question identified by the authors is whether greater documentation results in care that reflects patients’ goals. That would require examining what happens after plans are recorded, including whether clinicians can access and use those statements when treatment decisions arise.
The study report provides no announced follow-up schedule or plans for a wider rollout. For now, the findings offer evidence that the combined video-and-declaration approach increased planning recorded over 12 months in the participating clinics; its effects on care beyond documentation remain to be established.
Key Questions
What did the video decision aid explain?
It depicted three treatment options for advanced chronic kidney disease. Participants assigned to the intervention also recorded a video describing their goals, values and treatment preferences.
How many people took part?
The trial included 453 adults aged 65 and older with advanced kidney disease at 12 ambulatory clinics. Of these, 228 received the intervention and 225 received usual care.
How much did advance care planning documentation differ?
At 12 months, documentation was recorded for 56.6% of the intervention group and 40.0% of the usual-care group. The study also found more documented discussion of kidney failure treatment options in the intervention group.
Does the study show that patients received care matching their preferences?
No. The results reported higher documentation and differences in stated treatment preferences, but did not establish whether care ultimately matched those preferences. The authors said further research is needed to assess that question.
Source: medicalxpress.com
