Effectiveness of informational decision aids and a live donor financial assistance program on pursuit of live kidney transplants in African American hemodialysis patients
Date
2018Journal
BMC NephrologyPublisher
BioMed Central Ltd.Type
Article
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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. 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. 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. Copyright 2018 The Author(s).Keyword
Decision aidEnd stage renal disease
Financial support
Live donor kidney transplant
Race disparities
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https://www.scopus.com/inward/record.uri?eid=2-s2.0-85046488995&doi=10.1186%2fs12882-018-0901-x&partnerID=40&md5=6531d14c19b28848e2c00f9ac652a783; http://hdl.handle.net/10713/9747ae974a485f413a2113503eed53cd6c53
10.1186/s12882-018-0901-x
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