November 04, 2023
2 min read
- Patients in CKD clinics did not show a greater interest in kidney transplantation after receiving education from kidney care professionals.
- Patients could show interest in one of four educational modules.
PHILADELPHIA — An increase in patient education about living organ donation did not result in improvements in changing patient views of pursuing organ transplantation, according to data presented at ASN Kidney Week.
“Despite evidence of intervention uptake, the step completion rate did not significantly differ between the intervention vs. usual-care groups,” Amit X. Garg, MD, PhD, said during the High-Impact Clinical Trials session, here. “Results were consistent in multiple analyses.”
Garg, a professor with the departments of medicine and epidemiology and biostatistics and holds the endowed Dr. Adam Linton Chair in Kidney Health Analytics at Schulich Medicine & Dentistry at Western University, serves as the medical director for the Living Kidney Donor Program at London Health Sciences Centre and the site director for the Institute for Clinical Evaluative Sciences at Western University.
“Patients with advanced chronic kidney disease have the best chance for a longer and healthier life if they receive a kidney transplant,” Garg said. “However, many barriers prevent patients from receiving a transplant. We conducted a pragmatic, two-arm, parallel-group, cluster-randomized trial of a multi-component intervention designed to target several barriers which prevent kidney transplantation and living donation.”
The trial included patients in 26 CKD programs in Ontario, Canada, from November 2017 to December 2021. Using covariate constrained randomization, Garg and colleagues evenly divided the CKD programs to provide the intervention or usual care for 4.2 years.
Garg said the intervention had four main components – administrative support to establish local quality improvement teams; transplant educational resources; an initiative for transplant recipients and living donors to share stories and experiences; and program-level performance reports and oversight by administrative leaders. Primary outcome was a composite of all completed steps toward receiving a kidney transplant, Garg said.
Garg said patients could complete up to four steps in the process for the researchers to determine that the intervention was successful: referred to a transplant center for evaluation; had a potential living donor contact a transplant center for evaluation; added to the deceased donor waitlist; or received a transplant from a living or deceased donor.
The 26 CKD programs cared for 20,375 potentially transplant-eligible patients with advanced CKD. Overall, 9,780 patients received the interventional care during the study period and 10,595 patients received the usual care.
“This province-wide strategy did not increase the rate of completed steps toward receiving a kidney transplant. Improving access to transplantation remains a global priority. Future efforts can build on lessons learned,” Garg said.
Garg A, et al. FR-OR114. Presented at: ASN Kidney Week; Nov. 1-5, 2023; Philadelphia.
Garg A, et al. JAMA Intern Med. 2023; doi:10.1001/jamainternmed.2023.5802.