Table 9

Overview of studies evaluating the identified MIs

MI	Source	Population*	Sample size	Primary outcome(s)†	Secondary outcome(s)†	Main findings‡
Start PD or not?
No. 1	Quality improvement report146	Patients with CKD in the advanced stage	Total=63	Post-intervention: PD selection rate	n.a.	After the intervention there was an increase in PD selection from 8.8% to 15% over 2 years
What type of dialysis modality?
No. 2	Meeting abstract of retrospective cohort study156	Patients with stage 4 and 5 CKD Patients after unplanned dialysis start	Total=1141	Post-intervention: patient clinical characteristics, use of decision-making tools by patients, KRT modality choice, KRT modality start	n.a.	1141 patients were educated in 45 clinics Written information was largely used for 69%–95% of patients DVDs were used for 14%–30% of patients Treatment centre touring visits were used for 10%–76% of patients An increase in PD take-on occurred in the clinic-network after introduction of the structured modality information programme Most patients who chose PD (39%) were chronically ascribed to PD (31%), representing at least one-third of the suitable patients for both dialysis modalities
No. 2	Meeting abstract of retrospective cohort study157	Patients with stage 4 and 5 CKD	Total=2012	Post-intervention: patient clinical characteristics, use of decision-making tools by patients, KRT modality choice, KRT modality start	n.a.	2012 patients were educated in 48 clinics Written information was largely used for 97% of patients DVDs were used for 27% of patients Treatment centre touring visits were used for 49% of patients Most patients who chose PD (35%) were chronically ascribed to PD (31%); representing at least one-third of the suitable patients for both dialysis modalities
Transplantation or dialysis?
No. 3	Multicentre RCT147	Dialysis facilities	Total=134 RADIANT=67 Control=67	Pre-intervention and 12 months post-intervention: facility-level transplant referral	Patient and dialysis facility characteristics Pre-intervention and 12 months post-intervention: black versus white racial disparity in transplant referral, number of transplant evaluation starts, number of patients waitlisted for transplant	134 dialysis facilities, involving >9000 patients participated in the study Dialysis facilities in the intervention group referred a higher proportion of patients for transplantation at 12 months post-intervention (p<0.001) The difference between intervention and control dialysis facilities in the proportion of patients referred for transplant was higher among black than white patients (p<0.05)
No. 3	Multicentre prospective cohort study154	Dialysis facility staff members	Total=94	Post-intervention: staff, patient and dialysis facility characteristics Post-intervention: fidelity, sustainability, reach and context of the intervention, associations between process data and intervention outcomes	n.a.	Staff from 65 of the 67 dialysis facilities completed the questionnaire 50.8% reported high fidelity to the RADIANT intervention 63.1% reported that RADIANT was helpful or very helpful 90.8% were willing to continue with at least one of the intervention components after the study Variation in facility-level fidelity to RADIANT did not significantly influence the difference in the proportion of patients referred for transplant pre-intervention and post-intervention
No. 4	Quasi-experimental study148	Patients with an eGFR <30 mL/min/1.73 m²	Total=72 SDM programme=36 Control=36	Pre-intervention/control: patient and clinical characteristics, decisional conflict, decisional self-efficacy Immediately and 1 month post-intervention/control: decisional conflict, decisional self-efficacy	n.a.	Patients in the intervention group had a significant increase in decision self-efficacy and a significant decrease in decisional conflict immediately after (p<0.001, p<0.001) and 1 month after the intervention (p<0.001, p<0.001) The intervention group had significantly higher decision self-efficacy scores than the control group immediately after (p<0.001) and 1 month after the intervention (p<0.001) The intervention group had lower decisional conflict scores than the control group immediately after (p<0.001) and 1 month after the intervention (p<0.001)
Transplantation, dialysis or CCM?
No. 5	Retrospective cohort study149	Patients on HD	Total=93	Post-intervention: number of patients treated in the HD orientation unit, patient and clinical characteristics, distribution of treatment modality 1 year after operation of the HD orientation unit	n.a.	62% of patients transferred from in-centre HD to home HD, or were planning to do so 24% of patients transferred to CCM 41% of patients were able to self-puncture their fistulas after receiving the intervention
No. 6	Multicentre prospective cohort study150	Patients with CKD	Total=1044 SDM process for KRT choice=967	Post-intervention: patient and clinical characteristics, KRT choice and treatment initiation, chosen KRT modality and definitive KRT modality	n.a.	569 patients in that received the intervention made a KRT choice by the end of follow-up: 88.4% dialysis (43% HD and 45% PD), 3.2% pre-emptive LDKT and 8.4% CCM 399 patients began KRT during the post-intervention period: 93.4% dialysis (53.6% HD, 40%PD), 1.3% pre-emptive LDKT and 5.3% CCM Patients that received the intervention changed their mind about their KRT modality less than patients who did not receive the intervention The concordance between the final KRT choice and definitive modality in patients that received the intervention was higher compared with patients that did not receive the intervention Patients that did not receive the intervention chose PD less often and changed their decision more often compared with patients that did receive the intervention
No. 7	Retrospective cohort study151	Patients with eGFR <15 mL/min/1.73 m²	Total=102	Pre-intervention: treatment modality distribution Post-intervention: patient and clinical characteristics, timeline of each patients’ GUIDE process and the outcome of the steps, treatment modality distribution	n.a.	The intervention was started at a mean eGFR of 12 mL/min/1.73 m² 84% of patients were recommended to undergo dialysis of which 62.8% were recommended home dialysis 72% of patient that received the intervention chose dialysis, of which 42.5% chose a form of home dialysis (34.2% PD, 8.2% HD; home) 22.9% of patients that received the intervention started home dialysis as their first therapy compared with 17.6% of patients that did not receive the intervention 32.1% of patients that received dialysis therapy after the intervention received home dialysis compared with 19.5% of patients that did not receive the intervention
No. 8	Multicentre prospective cohort study152	Unplanned dialysis start patients	Total=270 UPS=214	Up to 12 months post-intervention: patient and clinical characteristics, the number of patients receiving and completing the programme, the number of patients making a dialysis modality decision, the final dialysis modality chosen, the number of patients receiving their chosen modality	n.a.	177 were able to decide on a dialysis modality after the intervention, of which 159 received their treatment of choice Initial dialysis modality and country specific practices were predictive of receiving the intervention (p=0.001, p=0.001) and dialysis modality decision-making (p<0.001, p=0.02) Age was predictive of receiving the intervention (p=0.01)
No. 8	Multicentre prospective cohort study155	Unplanned dialysis start patients	Total=270 UPS=214	Pre-intervention, 6 and 12 months post-intervention: patient and clinical characteristics, dialysis modality, details of when changed if changed, details of access procedures if changed, details of dialysis-related infectious events, number and length of hospitalisations, predictors of receiving PD or HD, flow of patients through the programme	n.a.	203 completed the intervention, after which 177 chose a dialysis modality (58% PD, 42% HD) Patients that did not complete the intervention were significantly older (p=0.01) and had a higher CCI (p<0.01) 86% of patients that chose PD and 95% of patients that chose HD received their treatment of choice Diabetes and receiving the intervention predicted receiving PD (p=0.03, p<0.001) Patients that chose PD had a higher CCI (p=0.01), prevalence of congestive heart failure (p<0.001), myocardial infarction (p=0.02) and were more likely in-patients (p=0.02) or referred from primary care (p=0.02) 11 year survival rates between PD or HD patients were comparable
No. 9	Retrospective cohort study153	Patients with an eGFR <15 mL/min/1.73 m²	Total=310 SDM for RRT=220	1 year post-intervention: patient- and clinical characteristics, evaluated for LDKT, receiving a LDKT, receiving PD or HD	n.a.	66 patients received PD, 67 patients entered the evaluation of LDKT and 18 patients received a LDKT 1 year after the intervention Compared with patients that did not receive the intervention there was an increase of 31.4% in patients receiving an evaluation for LDKT, an increase of 38.5% in patients receiving a LDKT and an increase of 112.9% in patients receiving PD 53% of patients that started PD after the intervention started without temporary HD as compared with 21.6% of patients that did not receive the intervention 91.3% of patients were satisfied with the intervention

*Population formulated as reported in the identified records.
†Outcomes formulated as reported in the identified records.
‡Main findings formulated as reported in the identified records.
CCI, Charlson Comorbidity Index; CCM, conservative care management; CKD, chronic kidney disease; eGFR, estimated glomerular filtration rate; HD, Haemodialysis; KRT, kidney replacement therapy; LDKT, living donor kidney transplantation; MIs, multicomponent initiatives; n.a., not applicable; PD, peritoneal dialysis; RADIANT, Reducing Disparities in Access to KidNey Transplantation; RCT, randomised controlled trial; RRT, renal replacement therapy; SDM, shared decision-making; UPS, unplanned dialysis start.