An explore transplant group randomized controlled education trial to increase dialysis patients’ decision-making and pursuit of transplantation

Amy D. Waterman*, John Devin Peipert

*Corresponding author for this work

Research output: Contribution to journalArticle

3 Citations (Scopus)

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 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.

Original languageEnglish (US)
Pages (from-to)174-183
Number of pages10
JournalProgress in Transplantation
Volume28
Issue number2
DOIs
StatePublished - Jan 1 2018

Fingerprint

Dialysis
Decision Making
Randomized Controlled Trials
Transplantation
Transplants
Education
Living Donors
Standard of Care
Patient Education
Odds Ratio

Keywords

  • Dialysis racial disparities
  • Kidney transplantation
  • Patient education
  • Randomized controlled trial

ASJC Scopus subject areas

  • Transplantation

Cite this

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title = "An explore transplant group randomized controlled education trial to increase dialysis patients’ decision-making and pursuit of transplantation",
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 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.",
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