Effectiveness of informational decision aids and a live donor financial assistance program on pursuit of live kidney transplants in African American hemodialysis patients.

Effectiveness of informational decision aids and a live donor financial assistance program on pursuit of live kidney transplants in African American hemodialysis patients. - 2018

Available online from MWHC library: 2000 - present

BACKGROUND: African Americans have persistently poor access to living donor kidney transplants (LDKT). We conducted a small randomized trial to provide preliminary evidence of the effect of informational decision support and donor financial assistance interventions on African American hemodialysis patients' pursuit of LDKT. CONCLUSIONS: Findings suggest these interventions may need to be paired with personal support or navigation services to overcome key communication, logistical, and financial barriers to LDKT. METHODS: Study participants were randomly assigned to receive (1) Usual Care; (2) the Providing Resources to Enhance African American Patients' Readiness to Make Decisions about Kidney Disease (PREPARED); or (3) PREPARED plus a living kidney donor financial assistance program. Our primary outcome was patients' actions to pursue LDKT (discussions with family, friends, or doctor; initiation or completion of the recipient LDKT medical evaluation; or identification of a donor). We also measured participants' attitudes, concerns, and perceptions of interventions' usefulness. RESULTS: Of 329 screened, 92 patients were eligible and randomized to Usual Care (n=31), PREPARED (n=30), or PREPARED plus financial assistance (n=31). Most participants reported interventions helped their decision making about renal replacement treatments (62%). However there were no statistically significant improvements in LDKT actions among groups over 6 months. Further, no participants utilized the living donor financial assistance benefit. TRIAL REGISTRATION: ClinicalTrials.gov [ NCT01439516 ] [August 31, 2011].


English

1471-2369

10.1186/s12882-018-0901-x [doi] 10.1186/s12882-018-0901-x [pii] PMC5934897 [pmc]


*African Americans
*Decision Support Techniques
*Financial Support
*Kidney Transplantation/mt [Methods]
*Living Donors
*Renal Dialysis/mt [Methods]
Adult
African Americans/px [Psychology]
Aged
Decision Making
Female
Health Knowledge, Attitudes, Practice
Humans
Kidney Transplantation/ec [Economics]
Kidney Transplantation/px [Psychology]
Living Donors/px [Psychology]
Male
Middle Aged
Patient Participation/ec [Economics]
Patient Participation/mt [Methods]
Patient Participation/px [Psychology]
Renal Dialysis/ec [Economics]
Renal Dialysis/px [Psychology]
Tissue and Organ Procurement
Treatment Outcome


MedStar Good Samaritan Hospital


Journal Article

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