Amy D Waterman1,2, John Devin Peipert1,2. 1. 1 Division of Nephrology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA. 2. 2 Terasaki Research Institute, Los Angeles, CA, USA.
Abstract
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 programincreased 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.
RCT Entities:
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.
Authors: Noel Engels; Gretchen N de Graav; Paul van der Nat; Marinus van den Dorpel; Anne M Stiggelbout; Willem Jan Bos Journal: BMJ Open Date: 2022-09-21 Impact factor: 3.006
Authors: Rachel E Patzer; Mengyu Di; Rebecca Zhang; Laura McPherson; Derek A DuBay; Matthew Ellis; Joshua Wolf; Heather Jones; Carlos Zayas; Laura Mulloy; Amber Reeves-Daniel; Sumit Mohan; Aubriana C Perez; Amal N Trivedi; Stephen O Pastan Journal: Am J Kidney Dis Date: 2022-03-14 Impact factor: 11.072
Authors: Janet Jull; Sascha Köpke; Maureen Smith; Meg Carley; Jeanette Finderup; Anne C Rahn; Laura Boland; Sandra Dunn; Andrew A Dwyer; Jürgen Kasper; Simone Maria Kienlin; France Légaré; Krystina B Lewis; Anne Lyddiatt; Claudia Rutherford; Junqiang Zhao; Tamara Rader; Ian D Graham; Dawn Stacey Journal: Cochrane Database Syst Rev Date: 2021-11-08
Authors: Amy D Waterman; John D Peipert; Yujie Cui; Jennifer L Beaumont; Andrea Paiva; Amanda F Lipsey; Crystal S Anderson; Mark L Robbins Journal: Am J Transplant Date: 2020-09-15 Impact factor: 8.086
Authors: Amy D Waterman; John D Peipert; Huiling Xiao; Christina J Goalby; Satoru Kawakita; Yujie Cui; Krista L Lentine Journal: Transplantation Date: 2020-02 Impact factor: 5.385
Authors: Amy D Waterman; Jim Gleason; Louise Lerminiaux; Emily H Wood; Alexander Berrios; Laurie A Meacham; Anne Osuji; Rachyl Pines; John D Peipert Journal: Curr Transplant Rep Date: 2020-09-01
Authors: Ahmed A Al-Jaishi; Kelly Carroll; Cory E Goldstein; Stephanie N Dixon; Amit X Garg; Stuart G Nicholls; Jeremy M Grimshaw; Charles Weijer; Jamie Brehaut; Lehana Thabane; P J Devereaux; Monica Taljaard Journal: Trials Date: 2020-08-28 Impact factor: 2.279