The National Palliative Care Research Center

Curing suffering through palliative care research.


Susan Wong MD

Assistant Professor

University of Washington

Grant Year
Grant Term
2 years
Grant Type

Project Description
A Decision Aid for the Conservative Management of Advanced Kidney Disease

Significance: Conservative care is palliative approach to caring for patients with advanced chronic kidney disease (CKD) who choose not to initiate maintenance dialysis. Despite calls for greater efforts to support shared decision-making for treatment of advanced CKD, available decision aids intended to assist patients with navigating these decisions focus primarily on of the benefits and harms of dialysis and include little or no information on conservative care. Approach: Aim 1: To conduct a qualitative study using cognitive interviews with 20-25 patients with advanced CKD and their close persons to ascertain how they process information about conservative care and uncover unmet needs and preferences for information on conservative care to inform a decision aid on conservative care; and Aim 2: To conduct a pilot study of the decision aid with 108 patients with advanced CKD and their close persons to evaluate its feasibility and acceptability and explore knowledge, confidence with decision-making and concordance between treatment decisions for advanced CKD with healthcare priorities gained with the aid. Innovation: The work will provide: 1) new insights on what information on conservative care patients and their close persons would like to receive and how it should be framed to better support decision-making for treatment of advanced CKD; and, 2) the first dedicated decision aid on conservative care for the US population. Investigator: Susan Wong is an early investigator and mentored by experts in geriatric nephrology (Ann O’Hare) and interventional trials in palliative care (J. Randall Curtis). Environment: The work will be situated at the Seattle VA Health Services Research and Development Center, which has been a leader in the evaluation of healthcare delivery and implementation science. Future Directions: The findings will inform R-level proposals to enhance and test the effectiveness of the decision aid in supporting shared decision-making for treatment of advanced CKD.

Susan P. Y. Wong, M.D., M.S. is an Assistant Professor of Medicine in the Division of Nephrology at the University of Washington, an Investigator at the Kidney Research Institute, and a nephrologist and Core Investigator at the VA Health Services Research and Development Center at the VA Puget Sound Health Care System in Seattle, WA. She received her medical degree from the University of Pittsburgh, and her internal medicine and nephrology training, master of science in epidemiology, and graduate certificates in palliative care and clinical ethics from the University of Washington. Dr. Wong conducts patient-oriented health services research on dialysis practices and end-of-life care among patients with advanced kidney disease.. Her goal is to create more patient-centered models of care for patients with kidney disease.