The ELDERLY Program
Background
An increasing number of elderly patients are reaching end-stage kidney disease (ESKD) in developed countries including Australia. The outcomes for elderly patients entering dialysis programs are poorer than that of younger patients, with lower survival rates, significant impacts on quality of life and high burden of time spent in hospital. There is also a comparably large number of elderly patients with ESKD who do not enter onto dialysis programs, some of which are managed in combined palliative care/renal supportive care clinics and some of which are solely managed in primary care. An understanding about differences in survival and other important patient outcomes including quality of life, symptom burden and time spent in hospital is limited, due to a lack of high-quality prospective data. In turn, individualised decision-making about treatment pathways for elderly ESKD patients is challenging and highly variable. The ELDERLY Program consists of the 4 sub-studies: OUTLOOK, TIMELY, CONTEND and Co-TIMELY.
OUTcomes Of Older patients with Kidney failure (OUTLOOK)
OUTLOOK is a multi-centre observational study aimed at enrolling patients ≥75 years with eGFR ≤15mL/min/1.73m2 who plan to but have not yet commenced dialysis, who are on a supportive care pathway, or who are undecided. Patients are followed prospectively with the primary outcomes of survival and receipt of dialysis. OUTLOOK is a routine care study and does not involve patient contact.
Current Status
OUTLOOK currently has 8 actively recruiting sites across QLD, NSW and VIC.
Treatment modalities for the InfirM ElderLY with end stage kidney disease (TIMELY)
TIMELY is also a multi-centre observational study that aims to enrol a subset of patients in OUTLOOK who have ability to complete and consent to patient questionnaires relating to quality of life, symptom burden, treatment decisions and time spent in hospital. Patients are enrolled and followed prospectively with yearly surveys. It aims to provide comparative data relating to important patient-reported outcomes.
Current Status
TIMELY currently has 7 actively recruiting sites across QLD and NSW.
CONsumer views of Treatment options for Elderly patieNts with kiDney failure (CONTEND)
CONTEND is a qualitative consumer engagement study aimed at exploring elderly patient and carer perspectives of ESKD, treatment decision-making and participation in research. The study aims to enrol patients ≥70 years and eGFR ≤15mL/min/1.73m2 who are undecided on a treatment pathway, or who have made a treatment decision within the last 2 years (including patients on dialysis).
Current status
CONTEND currently has 6 actively recruiting sites across NSW and VIC.
Caregivers of The InfirM ElderLY with end stage kidney disease (Co-TIMELY)
An increasing number of older patients are reaching end stage kidney disease (ESKD). Some of these patients will choose to be managed supportively and others by dialysis. Co-TIMELY will identify caregivers of older patients with ESKD and follow them for a median of 2 years. It is a sub-study of the larger TIMELY study and will examine caregiver quality of life (QOL), burden and experience.
Current status
Co-TIMELY currently has 3 actively recruiting sites across QLD and NSW.
