Baseline characteristics of participants in the NAVKIDS trial: a patient navigator program in children with chronic kidney disease.

Chandana Guha, Rabia Khalid, Anita van Zwieten, Anna Francis, Carmel M Hawley, Allison Jauré, Armando Teixeira-Pinto, Alistair R Mallard, Amelie Bernier-Jean, David W Johnson, Deirdre Hahn, Donna Reidlinger, Elaine M Pascoe, Elizabeth G Ryan, Fiona Mackie, Hugh J McCarthy, Jonathan C Craig, Julie Varghese, Charani Kiriwandeniya, Kirsten Howard, Nicholas G Larkins, Luke Macauley, Amanda Walker, Martin Howell, Michelle Irving, Patrina H Y Caldwell, Reginald Woodleigh, Shilpanjali Jesudason, Simon A Carter, Sean E Kennedy, Stephen I Alexander, Steven McTaggart, Germaine Wong

Journal: Pediatric nephrology (Berlin, Germany) 2023;38(5):1577-1590

PMID: 36264432

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 NAVKIDS 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 NAVKIDS 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.

© 2022. The Author(s), under exclusive licence to International Pediatric Nephrology Association.

Address: Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia.; Child and Adolescent Renal Services, Children's Health Queensland Hospital and Health Service, Brisbane, QLD, Australia.; Department of Nephrology, Princess Alexandra Hospital, Brisbane, QLD, Australia.; Australasian Kidney Trials Network, The University of Queensland, Brisbane, QLD, Australia.; Translational Research Institute, Brisbane, QLD, Australia.; School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, Australia.; CIUSSS du Nord-de-l'Île de Montréal, University of Montréal, Montreal, Canada.; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia.; Department of Nephrology, The Children's Hospital at Westmead, Sydney, NSW, Australia.; Australasian Kidney Trials Network, The University of Queensland, Brisbane, QLD, Australia.; Australasian Kidney Trials Network, The University of Queensland, Brisbane, QLD, Australia.; QCIF Facility for Advanced Bioinformatics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia.; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.; Department of Nephrology, Sydney Children's Hospital, Randwick, Sydney, NSW, Australia.; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia.; Department of Nephrology, Sydney Children's Hospital, Randwick, Sydney, NSW, Australia.; Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.; College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.; Menzies Centre for Health Policy and Economics and Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.; Department of Nephrology, Perth Children's Hospital, Perth, WA, Australia.; School of Medicine, University of Western Australia, Perth, WA, Australia.; Kidney Health Australia, Adelaide, SA, Australia.; Department of Nephrology, Royal Children's Hospital, Melbourne, VIC, Australia.; Murdoch Children's Research Institute, Melbourne, VIC, Australia.; Menzies Centre for Health Policy, The University of Sydney, Camperdown, Sydney, NSW, 2006, Australia.; Centre for Evidence and Implementation, 33 Lincoln Square South Carlton, Melbourne, VIC, 3053, Australia.; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia.; Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.; Prostate and Breast Cancer Foundation (CanCare), Sydney, NSW, Australia.; Central Northern Adelaide Renal and Transplantation Service (CNARTS), Royal Adelaide Hospital, Adelaide, SA, Australia.; Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia.; Department of Nephrology, Royal Children's Hospital, Melbourne, VIC, Australia.; Department of Nephrology, Sydney Children's Hospital, Randwick, Sydney, NSW, Australia.; School of Clinical Medicine, Faculty of Medicine & Health, University of New South Wales, Sydney, NSW, Australia.; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia.; Children's Health Queensland Hospital and Health Service, Brisbane, QLD, Australia.; The University of Queensland, Brisbane, QLD, Australia.; Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia. [email protected].; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia. [email protected].; Department of Renal Medicine, Westmead Hospital, Sydney, NSW, Australia. [email protected].
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