Observational StudyA Stakeholder-enhanced Intervention to Improve the Decisional Partnership of Chronic Kidney Disease Dyads (IMPART)

Inclusion Criteria:

• Patients

1. Age ≥18;
2. EMR documented diagnosis of stage 4 CKD (2 eGFR 29-15 within 90 days);
3. Ability to speak and read English and complete baseline questionnaires;
4. Patients must have an enrolled caregiver

Exclusion Criteria:

• Patients

1. Receiving hospice;
2. Receiving dialysis;
3. Medical record documentation of active unmedicated severe mental illness, moderate-severe dementia, suicidal ideation, uncorrected hearing loss, and active substance abuse.

Inclusion Criteria:

• Caregivers

1. Age ≥18;
2. Self-endorsing or identified by the patient as a relative, friend, or partner that has a close relationship with you and who assists you with your medical decisions and who may or may not live in the same residence as you and who is not paid for their help
3. Caring for a patient with CKD;
4. Ability to speak and read English and complete baseline questionnaires;
5. Caregivers must have an enrolled patient.

Exclusion Criteria:

• Caregivers 1) Self-reported unmedicated mental illness, Moderate-severe dementia, active suicidal ideation, uncorrected hearing loss, or active substance abuse ascertained by scripted study introduction questioning.