Patient-Reported Barriers to the Pre-Kidney Transplant Evaluation in an At-Risk Population in the United States.
1College of Nursing, University of Illinois at Chicago, Chicago, IL
2University of Chicago Medicine, Chicago, IL
Meeting: 2017 American Transplant Congress
Abstract number: C46
Keywords: African-American, Kidney transplantation, Multivariate analysis
Session Information
Session Name: Poster Session C: Disparity in Access and Outcomes for Solid Organ Transplantation
Session Type: Poster Session
Date: Monday, May 1, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
Background: Despite our knowledge of barriers to the early stages of the transplant process, we have limited insight into patient reported barriers to the pre-kidney transplant medical evaluation in populations largely at-risk for evaluation failure.
Methods: One-hundred consecutive adults were enrolled at an urban, Midwestern transplant center. Demographic, clinical and quality of life data were collected prior to subjects' visit with a transplant surgeon/nephrologist (evaluation begins). Patient-reported barriers to evaluation completion were collected using the Subjective Barriers Questionnaire 90-days after the initial medical evaluation appointment (evaluation ends), our center targeted goal for transplant work-up completion.
Results: At ninety days, 40% of participants had not completed the transplant evaluation. Five barrier categories were created from the eighty-five responses on the Subjective Barriers Questionnaire. Patient reported barriers included: Poor communication, physical health, socioeconomics, psychosocial influences, and access to care. Logistic regression analysis are presented in
| Table 1. Multiple logistic regression analysis | ||
| Unadjusted OR(95%CI),pvalue | Adjusted OR(95%CI)pvalue | |
| Race/ethicity (relative to white, non Hispanic) | ||
| Black, non-hispanic | 0.18(0.05-0.68),0.011 | 0.27(0.59-1.26),0.096 |
| Other (Hispanic, Asian, Pacific Islander) | 0.1(0.02-0.49),0.005 | 0.07(0.01-0.43),0.004 |
| Previous transplant (relative to no previous transplant) | 2.74(0.83-9.0),0.098 | 1.4(0.31-6.23)0.659 |
| dialysis status (relative to NYOD) | 0.27(0.09-0.78),0.016 | 0.20(0.04-0.9),0.036 |
| CCI (relative to <5) | 0.37(0.16-0.86),0.022 | 0.30(0.11-0.85),0.024 |
| Income (relative to <$40K/year) | 3.78(1.36-10.50),0.011 | 3.95(1.19-13.14),0.025 |
| HRQOL role-emotional (relative to < than the mean) | 1.95(0.86-4.50), 0.112 | 3.09(1.06-8.98),0.03 |
Conclusions: Poor communication between patients and providers, and among providers, was the most prominent patient reported barrier identified. Barriers were more prominent in marginalized groups such as ethnic minorities and people with low income. Understanding the prevalence of patient reported barriers may aid in the development of patient-centered interventions to improve completion rates.
CITATION INFORMATION: Lockwood M, Chon W, Josephson M, Becker Y, Saunders M. Patient-Reported Barriers to the Pre-Kidney Transplant Evaluation in an At-Risk Population in the United States. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Lockwood M, Chon W, Josephson M, Becker Y, Saunders M. Patient-Reported Barriers to the Pre-Kidney Transplant Evaluation in an At-Risk Population in the United States. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/patient-reported-barriers-to-the-pre-kidney-transplant-evaluation-in-an-at-risk-population-in-the-united-states/. Accessed November 22, 2024.« Back to 2017 American Transplant Congress