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

MedStar author(s):
Citation: BMC Nephrology. 19(1):107, 2018 May 03.PMID: 29724177Institution: MedStar Good Samaritan HospitalForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *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 OutcomeYear: 2018Local holdings: Available online from MWHC library: 2000 - presentISSN:
  • 1471-2369
Name of journal: BMC nephrologyAbstract: 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].All authors: Ameling J, Auguste P, Boulware LE, Campbell T, Choudhury KR, Cook C, Crews DC, Davenport CA, Ephraim PL, Gimenez L, Greer RC, Hanes DS, Jaar BG, Lamprea-Monteleagre JA, Lewis-Boyer L, Olufade T, Powe NR, Purnell TS, Rabb H, Ramamurthi H, Vilme H, Wang NY, Weir MR, Woodall AFiscal year: FY2018Digital Object Identifier: Date added to catalog: 2018-06-19
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 29724177 Available 29724177

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].

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