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In a randomized trial across 12 clinics, older adults with advanced chronic kidney disease who watched a treatment-options video and recorded their preferences had more advance care planning documentation at 12 months than those receiving usual care. The study measured documentation and treatment preferences; whether the approach leads to care that matches patients’ goals remains unknown.
A randomized trial involving 453 adults aged 65 and older with advanced chronic kidney disease found that those who watched a video about treatment options and recorded their preferences had more advance care planning (ACP) documentation in their electronic health records after 12 months than participants receiving usual care. The study, published in JAMA Internal Medicine, tested whether the approach could support discussion and documentation of choices as kidney disease advances.
The multicenter trial was conducted at 12 outpatient clinics. Researchers assigned 228 participants to the intervention and 225 to usual medical care. The intervention group watched a certified video describing three treatment options for advanced kidney disease, then made a video statement about their goals, values and treatment preferences. That statement was sent to each participant’s treating clinician.
At 12 months, ACP documentation was recorded for 56.6% of the intervention group, compared with 40.0% of the control group. Documentation of a discussion about kidney failure treatment options was also higher among intervention participants: 46.1%, compared with 31.6% in the control group.
The groups also differed in treatment preferences after the video intervention. Fewer participants in the intervention group were undecided about treatment than in the control group, 13.2% versus 41.3%. More preferred conservative kidney management, 50.7% versus 31.8%. These figures describe the trial’s reported outcomes; they do not establish that every participant received the treatment they preferred.
More Preferences Entered in Medical Records
ACP documentation can give patients and clinicians a record of goals and preferences to refer to when discussing future care. The trial’s findings suggest that pairing standardized information with a patient-authored statement may help make those preferences more visible in routine kidney care. The documented increase matters because a conversation or preference may not otherwise be captured in the electronic health record.
However, the study measured documentation and recorded preferences, not whether care ultimately matched those preferences or improved health outcomes. A higher rate of recorded plans is a process measure. Whether the video aid changes decisions at later stages of illness, supports families and clinicians, or improves alignment between care and patient goals requires further research.
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How the Kidney Care Trial Worked
The study examined older adults with advanced chronic kidney disease, a group facing decisions about possible treatment approaches as kidney failure progresses. The report describes three options presented in the video, but does not name each option in its summary. It does report that conservative kidney management was selected more often by intervention participants after viewing the aid.
The research was led by Angelo E. Volandes of Dartmouth Health and colleagues. The paper, “Video Decision Support and Advance Care Planning in Older Adults With Advanced Kidney Disease,” appeared in JAMA Internal Medicine in 2026 and was published to coincide with Kidney Week, the American Society of Nephrology’s annual meeting held in Denver from Oct. 21 to 25.
““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, as quoted in the report
Whether Plans Guide Later Care
The findings do not show whether the higher documentation rate resulted in care that matched participants’ stated goals. The source report also does not provide details on outcomes such as quality of life, treatment uptake, or patient and family experiences after the 12-month assessment. Those measures would help clarify the practical effects of adding the video and recorded statement to clinic care.
The summary does not specify how participants were followed after the trial, how often clinicians viewed or discussed the recorded statements, or whether the effect differed across clinics or patient groups. The reported results should be understood as findings from this trial, not as evidence that the approach will have the same impact in every setting.
Further Research on Goal-Matched Care
The study authors say further research is needed to test whether increased ACP documentation translates into care consistent with patients’ goals. Future evaluation could examine how clinicians use the recorded statements and whether documented preferences remain available and relevant as a person’s health changes. The report does not identify a specific next trial or timeline, so further research plans remain unclear.
For now, the published results establish that the intervention was associated with higher documentation and different recorded treatment preferences over 12 months in the participating clinics. They do not establish that video decision aids should replace clinician conversations or determine which option is right for any individual patient.
Key Questions
What did the video decision aid involve?
Participants watched a certified video describing three treatment options for advanced kidney disease, then recorded their goals, values and preferences in a video statement that was sent to their clinician.
How many people took part?
The trial included 453 adults aged 65 and older with advanced chronic kidney disease: 228 received the intervention and 225 received usual medical care.
How did advance care planning documentation differ?
At 12 months, ACP documentation was recorded for 56.6% of intervention participants and 40.0% of control participants. The study also reported more documented discussions of kidney failure treatment options in the intervention group.
Does the study show that patients received care matching their preferences?
No. The reported results cover documentation and stated preferences. The authors said further research is needed to determine whether increased documentation leads to care that matches patients’ goals.
Source: medicalxpress.com
