TY - JOUR
T1 - Your Path to Transplant
T2 - A randomized controlled trial of a tailored expert system intervention to increase knowledge, attitudes, and pursuit of kidney transplant
AU - Waterman, Amy D.
AU - Peipert, John D.
AU - Cui, Yujie
AU - Beaumont, Jennifer L.
AU - Paiva, Andrea
AU - Lipsey, Amanda F.
AU - Anderson, Crystal S.
AU - Robbins, Mark L.
N1 - Funding Information:
Funding for this study was provided by the National Institutes of Health (R01DK088711; T32DK104687).
Publisher Copyright:
© 2020 The American Society of Transplantation and the American Society of Transplant Surgeons
PY - 2021/3
Y1 - 2021/3
N2 - Individually tailoring education over time may help more patients, especially racial/ethnic minorities, get waitlisted and pursue deceased and living donor kidney transplant (DDKT and LDKT, respectively). We enrolled 802 patients pursuing transplant evaluation at the University of California, Los Angeles Transplant Program into a randomized education trial. We compared the effectiveness of Your Path to Transplant (YPT), an individually tailored coaching and education program delivered at 4 time points, with standard of care (SOC) education on improving readiness to pursue DDKT and LDKT, transplant knowledge, taking 15 small transplant-related actions, and pursuing transplant (waitlisting or LDKT rates) over 8 months. Survey outcomes were collected prior to evaluation and at 4 and 8 months. Time to waitlisting or LDKT was assessed with at least 18 months of follow-up. At 8 months, compared to SOC, the YPT group demonstrated increased LDKT readiness (47% vs 33%, P =.003) and transplant knowledge (effect size [ES] = 0.41, P <.001). Transplant pursuit was higher in the YPT group (hazard ratio: 1.44, 95% confidence interval: 1.15-1.79, P =.002). A focused, coordinated education effort can improve transplant-seeking behaviors and waitlisting rates. ClinicalTrials.gov registration: NCT02181114.
AB - Individually tailoring education over time may help more patients, especially racial/ethnic minorities, get waitlisted and pursue deceased and living donor kidney transplant (DDKT and LDKT, respectively). We enrolled 802 patients pursuing transplant evaluation at the University of California, Los Angeles Transplant Program into a randomized education trial. We compared the effectiveness of Your Path to Transplant (YPT), an individually tailored coaching and education program delivered at 4 time points, with standard of care (SOC) education on improving readiness to pursue DDKT and LDKT, transplant knowledge, taking 15 small transplant-related actions, and pursuing transplant (waitlisting or LDKT rates) over 8 months. Survey outcomes were collected prior to evaluation and at 4 and 8 months. Time to waitlisting or LDKT was assessed with at least 18 months of follow-up. At 8 months, compared to SOC, the YPT group demonstrated increased LDKT readiness (47% vs 33%, P =.003) and transplant knowledge (effect size [ES] = 0.41, P <.001). Transplant pursuit was higher in the YPT group (hazard ratio: 1.44, 95% confidence interval: 1.15-1.79, P =.002). A focused, coordinated education effort can improve transplant-seeking behaviors and waitlisting rates. ClinicalTrials.gov registration: NCT02181114.
KW - donor nephrectomy
KW - donors and donation: donor evaluation
KW - education
KW - health services and outcomes research
KW - kidney disease
KW - kidney transplantation/nephrology
KW - kidney transplantation: living donor
KW - organ transplantation in general
KW - translational research/science
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U2 - 10.1111/ajt.16262
DO - 10.1111/ajt.16262
M3 - Article
C2 - 33245618
AN - SCOPUS:85090939618
VL - 21
SP - 1186
EP - 1196
JO - American Journal of Transplantation
JF - American Journal of Transplantation
SN - 1600-6135
IS - 3
ER -