Kayse Lee Maass1, Abigail R Smith2, Emily L Tucker3, Hannah Schapiro3, Sabrina M Cottrell3, Evelyn Gendron3, Peg Hill-Callahan4, Stephen J Gill5, Mark S Daskin3, Robert M Merion6, Alan B Leichtman7. 1. Department of Mechanical and Industrial Engineering, Northeastern University, Boston, USA; Department of Industrial and Operations Engineering, University of Michigan, Ann Arbor, USA. 2. Department of Biostatistics, University of Michigan, Ann Arbor, USA; Arbor Research Collaborative for Health, Ann Arbor, USA. 3. Department of Industrial and Operations Engineering, University of Michigan, Ann Arbor, USA. 4. Arbor Research Collaborative for Health, Ann Arbor, USA. 5. Stephen J. Gill Consulting, Ann Arbor, USA. 6. Arbor Research Collaborative for Health, Ann Arbor, USA; Department of Surgery, University of Michigan, Ann Arbor, USA. 7. Arbor Research Collaborative for Health, Ann Arbor, USA; Department of Internal Medicine, University of Michigan, Ann Arbor, USA. Electronic address: alan.leichtman@arborresearch.org.
Abstract
OBJECTIVE: This study examined whether kidney transplant recipients' post-transplant goals and expectations align with those as perceived by their healthcare providers. METHODS: Post-transplant goals and expectations across four domains were assessed via a descriptive survey of healthcare providers (N=72) and kidney transplant recipients (N=476) at the University of Michigan from March 23 - October 1, 2015. Demographic and transplant-related data were collected via a retrospective review of medical records, and survey responses were compared using Chi-square tests, Wilcoxon two-sample tests, and logistic regression. RESULTS: Patients expressed higher quality of life (mean Neuro-QOL T-score 60.2 vs. 52.7), were less likely to report that they were currently experiencing complications (11% vs. 24%), and anticipated their transplants to last longer (median 25 vs. 15 years) and to live longer (median 80 vs. 71 years) than providers expected for their typical patient. However, provider perceptions of patients' future ability to feel well, perform daily activities and work were significantly higher than those expressed by patients (all p<0.05). CONCLUSION: Kidney transplant patient and provider expectations differ in significant ways. PRACTICE IMPLICATIONS: Identified areas of discordance may provide opportunities for patients and providers to better evaluate treatment option tradeoffs in post-transplant clinical interactions.
OBJECTIVE: This study examined whether kidney transplant recipients' post-transplant goals and expectations align with those as perceived by their healthcare providers. METHODS: Post-transplant goals and expectations across four domains were assessed via a descriptive survey of healthcare providers (N=72) and kidney transplant recipients (N=476) at the University of Michigan from March 23 - October 1, 2015. Demographic and transplant-related data were collected via a retrospective review of medical records, and survey responses were compared using Chi-square tests, Wilcoxon two-sample tests, and logistic regression. RESULTS:Patients expressed higher quality of life (mean Neuro-QOL T-score 60.2 vs. 52.7), were less likely to report that they were currently experiencing complications (11% vs. 24%), and anticipated their transplants to last longer (median 25 vs. 15 years) and to live longer (median 80 vs. 71 years) than providers expected for their typical patient. However, provider perceptions of patients' future ability to feel well, perform daily activities and work were significantly higher than those expressed by patients (all p<0.05). CONCLUSION: Kidney transplant patient and provider expectations differ in significant ways. PRACTICE IMPLICATIONS: Identified areas of discordance may provide opportunities for patients and providers to better evaluate treatment option tradeoffs in post-transplant clinical interactions.
Authors: Emily L Tucker; Abigail R Smith; Mark S Daskin; Hannah Schapiro; Sabrina M Cottrell; Evelyn S Gendron; Peg Hill-Callahan; Alan B Leichtman; Robert M Merion; Stephen J Gill; Kayse Lee Maass Journal: BMC Nephrol Date: 2019-05-16 Impact factor: 2.388