TY - JOUR
T1 - An explore transplant group randomized controlled education trial to increase dialysis patients’ decision-making and pursuit of transplantation
AU - Waterman, Amy D.
AU - Peipert, John Devin
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Health Resources and Services Agency (R39OT05429).
Publisher Copyright:
© 2018, NATCO. All rights reserved.
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Introduction: Dialysis centers must provide transplant education to patients but often do not address the risks and benefits of living and deceased donor transplant. Research Questions: In a group randomized controlled trial of 20 dialysis centers and 253 patients, we assessed whether the Explore Transplant education program increased patients’ readiness to pursue transplant, transplant knowledge, informed transplant decision-making, discussions about transplant with potential living donors, pursuit and receipt of living or deceased donor transplant, and whether these effects varied by race. Methods: Patients at participating dialysis centers were randomized to receive either (1) a 4-module Explore Transplant education program, including videos, printed materials, and transplant educator discussions or (2) standard-of-care transplant education provided by dialysis centers. The trial had 3 phases: (1) pre- and postsurveying and dialysis center education (2007-2008), (2) follow-up to determine whether patients restarted or began transplant evaluation (2008-2010), and (3) assessment of participants’ receipt of a renal transplant (2012-2015). Results: Compared to patients in standard-of-care dialysis centers, patients who received the intervention were more likely to increase in their stage of readiness for living donor transplantation (odds ratio: 2.50; 95% confidence interval: 1.10- 5.66), had greater increases in their transplant knowledge (P < .001), and were more likely to call to restart/begin transplant evaluation (38% vs 24%, P = .006). When analyses were stratified by race, black patients were more likely to take several steps toward transplant in comparison to whites. Discussion: The Explore Transplant helps dialysis patients make informed decisions and increases their pursuit of transplant, particularly among black patients.
AB - Introduction: Dialysis centers must provide transplant education to patients but often do not address the risks and benefits of living and deceased donor transplant. Research Questions: In a group randomized controlled trial of 20 dialysis centers and 253 patients, we assessed whether the Explore Transplant education program increased patients’ readiness to pursue transplant, transplant knowledge, informed transplant decision-making, discussions about transplant with potential living donors, pursuit and receipt of living or deceased donor transplant, and whether these effects varied by race. Methods: Patients at participating dialysis centers were randomized to receive either (1) a 4-module Explore Transplant education program, including videos, printed materials, and transplant educator discussions or (2) standard-of-care transplant education provided by dialysis centers. The trial had 3 phases: (1) pre- and postsurveying and dialysis center education (2007-2008), (2) follow-up to determine whether patients restarted or began transplant evaluation (2008-2010), and (3) assessment of participants’ receipt of a renal transplant (2012-2015). Results: Compared to patients in standard-of-care dialysis centers, patients who received the intervention were more likely to increase in their stage of readiness for living donor transplantation (odds ratio: 2.50; 95% confidence interval: 1.10- 5.66), had greater increases in their transplant knowledge (P < .001), and were more likely to call to restart/begin transplant evaluation (38% vs 24%, P = .006). When analyses were stratified by race, black patients were more likely to take several steps toward transplant in comparison to whites. Discussion: The Explore Transplant helps dialysis patients make informed decisions and increases their pursuit of transplant, particularly among black patients.
KW - Dialysis racial disparities
KW - Kidney transplantation
KW - Patient education
KW - Randomized controlled trial
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U2 - 10.1177/1526924818765815
DO - 10.1177/1526924818765815
M3 - Article
C2 - 29699451
AN - SCOPUS:85046783982
SN - 1526-9248
VL - 28
SP - 174
EP - 183
JO - Progress in Transplantation
JF - Progress in Transplantation
IS - 2
ER -