Chandana Guha1,2, Rabia Khalid1,2, Anita van Zwieten1,2, Anna Francis3, Carmel M Hawley4,5,6, Allison Jauré1,2, Armando Teixeira-Pinto1,2, Alistair R Mallard7, Amelie Bernier-Jean8, David W Johnson4,5,6, Deirdre Hahn2,9, Donna Reidlinger5, Elaine M Pascoe5, Elizabeth G Ryan5,10,11, Fiona Mackie12, Hugh J McCarthy2,12,13, Jonathan C Craig14, Julie Varghese5, Charani Kiriwandeniya5, Kirsten Howard15, Nicholas G Larkins16,17, Luke Macauley18, Amanda Walker19,20, Martin Howell1,2, Michelle Irving21,22, Patrina H Y Caldwell2,13, Reginald Woodleigh23, Shilpanjali Jesudason24, Simon A Carter1,2,19, Sean E Kennedy12,25, Stephen I Alexander2, Steven McTaggart26,27, Germaine Wong28,29,30. 1. Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia. 2. Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia. 3. Child and Adolescent Renal Services, Children's Health Queensland Hospital and Health Service, Brisbane, QLD, Australia. 4. Department of Nephrology, Princess Alexandra Hospital, Brisbane, QLD, Australia. 5. Australasian Kidney Trials Network, The University of Queensland, Brisbane, QLD, Australia. 6. Translational Research Institute, Brisbane, QLD, Australia. 7. School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, Australia. 8. CIUSSS du Nord-de-l'Île de Montréal, University of Montréal, Montreal, Canada. 9. Department of Nephrology, The Children's Hospital at Westmead, Sydney, NSW, Australia. 10. QCIF Facility for Advanced Bioinformatics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia. 11. School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. 12. Department of Nephrology, Sydney Children's Hospital, Randwick, Sydney, NSW, Australia. 13. Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia. 14. College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia. 15. Menzies Centre for Health Policy and Economics and Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia. 16. Department of Nephrology, Perth Children's Hospital, Perth, WA, Australia. 17. School of Medicine, University of Western Australia, Perth, WA, Australia. 18. Kidney Health Australia, Adelaide, SA, Australia. 19. Department of Nephrology, Royal Children's Hospital, Melbourne, VIC, Australia. 20. Murdoch Children's Research Institute, Melbourne, VIC, Australia. 21. Menzies Centre for Health Policy, The University of Sydney, Camperdown, Sydney, NSW, 2006, Australia. 22. Centre for Evidence and Implementation, 33 Lincoln Square South Carlton, Melbourne, VIC, 3053, Australia. 23. Prostate and Breast Cancer Foundation (CanCare), Sydney, NSW, Australia. 24. Central Northern Adelaide Renal and Transplantation Service (CNARTS), Royal Adelaide Hospital, Adelaide, SA, Australia. 25. School of Clinical Medicine, Faculty of Medicine & Health, University of New South Wales, Sydney, NSW, Australia. 26. Children's Health Queensland Hospital and Health Service, Brisbane, QLD, Australia. 27. The University of Queensland, Brisbane, QLD, Australia. 28. Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia. germaine.wong@health.nsw.gov.au. 29. Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia. germaine.wong@health.nsw.gov.au. 30. Department of Renal Medicine, Westmead Hospital, Sydney, NSW, Australia. germaine.wong@health.nsw.gov.au.
Abstract
BACKGROUND: Children with chronic kidney disease (CKD) require multidisciplinary care to meet their complex healthcare needs. Patient navigators are trained non-medical personnel who assist patients and caregivers to overcome barriers to accessing health services through care coordination. This trial aims to determine the effectiveness of a patient navigator program in children with CKD. METHODS: The NAVKIDS2 trial is a multi-center, waitlisted, randomized controlled trial of patient navigators in children with CKD conducted at five sites across Australia. Children (0-16 years) with CKD from low socioeconomic status rural or remote areas were randomized to an intervention group or a waitlisted control group (to receive intervention after 6 months). The study primary and secondary endpoints include the self-rated health (SRH) (primary), and utility-based quality of life, progression of kidney dysfunction of the child, SRH, and satisfaction with healthcare of the caregiver at 6 months post-randomization. RESULTS: The trial completed recruitment in October 2021 with expected completion of follow-up by October 2022. There were 162 patients enrolled with 80 and 82 patients randomized to the immediate intervention and waitlisted groups, respectively. Fifty-eight (36%) participants were from regional/remote areas, with a median (IQR) age of 9.5 (5.0, 13.0) years, 46% were of European Australian ethnicity, and 65% were male. A total of 109 children (67%) had CKD stages 1-5, 42 (26%) were transplant recipients, and 11 (7%) were receiving dialysis. CONCLUSION: The NAVKIDS2 trial is designed to evaluate the effectiveness of patient navigation in children with CKD from families experiencing socioeconomic disadvantage. A higher resolution version of the Graphical abstract is available as Supplementary information.
BACKGROUND: Children with chronic kidney disease (CKD) require multidisciplinary care to meet their complex healthcare needs. Patient navigators are trained non-medical personnel who assist patients and caregivers to overcome barriers to accessing health services through care coordination. This trial aims to determine the effectiveness of a patient navigator program in children with CKD. METHODS: The NAVKIDS2 trial is a multi-center, waitlisted, randomized controlled trial of patient navigators in children with CKD conducted at five sites across Australia. Children (0-16 years) with CKD from low socioeconomic status rural or remote areas were randomized to an intervention group or a waitlisted control group (to receive intervention after 6 months). The study primary and secondary endpoints include the self-rated health (SRH) (primary), and utility-based quality of life, progression of kidney dysfunction of the child, SRH, and satisfaction with healthcare of the caregiver at 6 months post-randomization. RESULTS: The trial completed recruitment in October 2021 with expected completion of follow-up by October 2022. There were 162 patients enrolled with 80 and 82 patients randomized to the immediate intervention and waitlisted groups, respectively. Fifty-eight (36%) participants were from regional/remote areas, with a median (IQR) age of 9.5 (5.0, 13.0) years, 46% were of European Australian ethnicity, and 65% were male. A total of 109 children (67%) had CKD stages 1-5, 42 (26%) were transplant recipients, and 11 (7%) were receiving dialysis. CONCLUSION: The NAVKIDS2 trial is designed to evaluate the effectiveness of patient navigation in children with CKD from families experiencing socioeconomic disadvantage. A higher resolution version of the Graphical abstract is available as Supplementary information.
Authors: Rowena Lalji; Anna Francis; Germaine Wong; Andrea K Viecelli; Allison Tong; Armando Teixeira-Pinto; Mignon McCulloch; Aminu K Bello; Adeera Levin; Meaghan Lunney; Mohamed A Osman; Feng Ye; Vivekanand Jha; John Feehally; David C Harris; David W Johnson Journal: Kidney Int Date: 2020-09 Impact factor: 10.612
Authors: Lilia Cervantes; Romana Hasnain-Wynia; John F Steiner; Michel Chonchol; Stacy Fischer Journal: Am J Kidney Dis Date: 2019-09-09 Impact factor: 8.860
Authors: Tom D Blydt-Hansen; Christopher B Pierce; Yi Cai; Dmitri Samsonov; Susan Massengill; Marva Moxey-Mims; Bradley A Warady; Susan L Furth Journal: Clin J Am Soc Nephrol Date: 2013-11-21 Impact factor: 8.237
Authors: Kerry A McBrien; Noah Ivers; Lianne Barnieh; Jacob J Bailey; Diane L Lorenzetti; David Nicholas; Marcello Tonelli; Brenda Hemmelgarn; Richard Lewanczuk; Alun Edwards; Ted Braun; Braden Manns Journal: PLoS One Date: 2018-02-20 Impact factor: 3.240