Increasing live donor kidney transplantation: a randomized controlled trial of a home-based educational intervention.
With the shortage of deceased donor kidneys and the superior clinical outcomes possible with live donor kidney transplantation (LDKT), more patients should seriously consider LDKT. However, little is known about how best to educate patients and their family members about LDKT. We evaluated the effectiveness of a home-based (HB) educational program in increasing LDKT. Patients were randomized to clinic-based (CB) education alone (CB, n = 69) or CB plus HB education (CB+HB, n = 63). Compared to CB, more patients in the CB+HB group had living donor inquiries (63.8% vs. 82.5%, p = 0.019) and evaluations (34.8% vs. 60.3%, p = 0.005) and LDKTs (30.4% vs. 52.4%, p = 0.013). Assignment to the CB+HB group, White race, more LDKT knowledge, higher willingness to discuss LDKT with others, and fewer LDKT concerns were predictors of having LDKT (p-values < 0.05). Both groups demonstrated an increase in LDKT knowledge after the CB education, but CB+HB led to an additional increase in LDKT knowledge (p < 0.0001) and in willingness to discuss LDKT with others (p < 0.0001), and a decrease in LDKT concerns (p < 0.0001). Results indicate that an HB outreach program is more effective in increasing LDKT rates than CB education alone.
Rodrigue
J R
JR
The Transplant Center and the Department of Psychiatry, Beth Israel Deaconess Medical Center, 110 Francis Street, LMOB-7th Floor, Boston, Massachusetts, USA. jrrodrig@bidmc.harvard.edu
Cornell
D L
DL
Lin
J K
JK
Kaplan
B
B
Howard
R J
RJ
D000328:Adult; D000554:Ambulatory Care Facilities; D003159:Community-Institutional Relations; D003657:Decision Making; D005260:Female; D006699:Home Care Services; D006801:Humans; D016030:Kidney Transplantation / Q000193:education* / Q000523:psychology / Q000706:statistics & numerical data*; D019520:Living Donors / Q000193:education* / Q000523:psychology / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000191:economics / Q000379:methods*; D018579:Patient Selection; D011446:Prospective Studies