Date: Tuesday, June 4, 2019
Session Time: 2:30pm-4:00pm
Presentation Time: 3:42pm-3:54pm
Location: Room 302
*Purpose: To increase preemptive and early transplant rates, transplant education must be delivered along the entire chronic kidney disease (CKD) spectrum. To understand patients’ education preferences by CKD Stage and primary language spoken, barriers to education, and opportunities for improvement, we interviewed 30 CKD Stage 3-4 patients, 10 ESRD patients [22% White; 50% Hispanic; 13% Black; 15% Other], 13 family members, and 10 providers [nephrologists, social workers, nurses, transplant coordinators, and dieticians] at Kaiser Permanente Southern California (KPSC).
*Methods: A grounded theory analysis identified central educational improvement themes for KPSC CKD 3-5 patients.
*Results: Providers felt that patients had cultural and financial barriers to transplant as well as family histories preventing living donation. Patients generally stated barriers of fears about and lack of family support for transplant. Spanish-speaking patients reported less relationship with their nephrologists and more language barriers over other patient groups. Timing of transplant education preferences varied by CKD Stage; Early CKD patients wanted more education about ESRD prevention versus transplant; ESRD patients wanted transplant information earlier than they received it.
All interviewees wanted multiple, smaller modules of education over time as CKD progresses, dedicated LDKT materials, and education in multiple languages. Patients and family members wanted access to online educational resources, preferably videos; opportunities to hear from ESRD patients and donors; Optional peer support groups. Providers recommended proper timing of education delivery; greater guidance in CKD decision-making; monitoring of patient learning; and awareness campaigns to locate potential living donors.
*Conclusions: Patients can be overwhelmed by the complexity of transplant and LDKT. Patients and providers recommend delivering smaller, more digestible amounts of transplant-related content in CKD 3-4, with discussions with providers and access to support groups increasing as ESRD approaches. Implementing these improvements consistently, in multiple languages, within a large coordinated care delivery system like KPSC could increase preemptive and early transplant rates.
To cite this abstract in AMA style:Waterman AD, Ranasinghe ON, Lipsey AF, Anderson CS, Alem A, Bozzolo C, Dub B, Henry SL, Mittman B. Earlier Transplant Education as CKD Progresses? CKD 3-5 Patients and Providers Weigh In [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/earlier-transplant-education-as-ckd-progresses-ckd-3-5-patients-and-providers-weigh-in/. Accessed April 15, 2021.
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