BACKGROUND: We sought to determine the accuracy of dialysis medical records in identifying patients' interest in and suitability for transplantation. STUDY DESIGN: Cluster randomized controlled trial. SETTING AND PARTICIPANTS: A total of 167 patients recruited from 23 hemodialysis facilities. INTERVENTION: Navigators met with intervention patients to provide transplant information and assistance. Control patients continued to receive usual care. OUTCOMES: Agreement at study initiation between medical records and (i) patient self-reported interest in transplantation and (ii) study assessments of medical suitability for transplant referral. MEASUREMENTS: Medical record assessments, self-reports, and study assessments of patient's interest in and suitability for transplantation. RESULTS: There was disagreement between medical records and patient self-reported interest in transplantation for 66 (40%) of the 167 study patients. In most of these cases, patients reported being more interested in transplantation than their medical records indicated. The study team determined that all 92 intervention patients were medically suitable for transplant referral. However, for 38 (41%) intervention patients, medical records indicated that they were not suitable. About two-thirds of these patients successfully moved forward in the transplant process. CONCLUSION: Dialysis medical records are frequently inaccurate in determining patient's interest in and suitability for transplantation.
RCT Entities:
BACKGROUND: We sought to determine the accuracy of dialysis medical records in identifying patients' interest in and suitability for transplantation. STUDY DESIGN: Cluster randomized controlled trial. SETTING AND PARTICIPANTS: A total of 167 patients recruited from 23 hemodialysis facilities. INTERVENTION: Navigators met with intervention patients to provide transplant information and assistance. Control patients continued to receive usual care. OUTCOMES: Agreement at study initiation between medical records and (i) patient self-reported interest in transplantation and (ii) study assessments of medical suitability for transplant referral. MEASUREMENTS: Medical record assessments, self-reports, and study assessments of patient's interest in and suitability for transplantation. RESULTS: There was disagreement between medical records and patient self-reported interest in transplantation for 66 (40%) of the 167 study patients. In most of these cases, patients reported being more interested in transplantation than their medical records indicated. The study team determined that all 92 intervention patients were medically suitable for transplant referral. However, for 38 (41%) intervention patients, medical records indicated that they were not suitable. About two-thirds of these patients successfully moved forward in the transplant process. CONCLUSION: Dialysis medical records are frequently inaccurate in determining patient's interest in and suitability for transplantation.
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