12 July 2018
Children with chronic kidney disease
Recruitment site location(s) (State)
New South Wales, Queensland, Victoria
Not yet recruiting
Anticipated date of first participant enrolment
04 March 2019
Ethics application status
The NAVKID2 trial is a multi-centre, staggered entry, waitlisted randomised controlled trial that assesses the health benefits and costs of a patient navigator program in children with chronic kidney disease (CKD) stages 3-5, on dialysis (CKD-D) and with kidney transplants (CKD-T) and of low socioeconomic backgrounds. CKD is a devastating illness associated with increased mortality, reduced quality of life, impaired growth, neurocognitive impairment and psychosocial maladjustment in children. The overall annual mortality rate for children on dialysis is 35 per 1000 population and is thirty-fold higher than children without CKD. Such large discrepancies in mortality rates remain unchanged despite medical advances over the past two decades. The key findings of our observational KCAD study indicated that poor health in children with CKD is not only attributed to the direct influence of the chronic illness but also reflects outcomes of the complex pathway that defines equitable access to healthcare. We found that children with CKD of the lowest and second lowest socioeconomic status (SES) quartiles were at least 3 and 2 times more likely to experience poorer overall health compared to the highest SES quartile.
Patient navigators are trained non-medical personnel who assist patients with complex and/or chronic conditions journey through the continuum of care and transit across different care settings. They help the vulnerable and underserved populations with chronic illness to better understand their diagnoses, treatment options, and available resources, to guide them through the very complex medical system and to overcome barriers to health care access and bridge gaps in transitions of care. Using a staggered entry, waitlist randomised control design, this study will aim to: 1. Assesses the impact of a patient navigator program on the overall health and well-being of children with CKD in a multi-centre, staggered-entry, waitlisted randomised controlled trial.
2. Determine the cost-effectiveness of a patient-navigator program compare with standard care.
3. Identify the barriers and facilitators of developing and implementing a patient navigator program in clinical practice.