Implementation of the Kidney Team at Home Intervention: Evaluating Generalizability, Implementation Process, and Effects

S. Redeker¹, S. Ismail¹, R. Timman¹, J. van Busschbach¹, C. Boonstra², H. F. Brulez³, D. A. Hollander⁴, L. Hilbrands⁵, F. J. Bemelman⁶, S. P. Berger⁷, J. van der Wetering⁸, R. A. van den Dorpel⁹, M. A. Jansen-Dekker¹⁰, W. Weimar⁸, E. K. Massey⁸

¹Psychiatry, Erasmus MC, Rotterdam, Netherlands, ²De Viersprong, Rotterdam, Netherlands, ³Internal Medicine, OLVG, Amsterdam, Netherlands, ⁴Internal Medicine, JBZ, Den Bosch, Netherlands, ⁵Internal Medicine, Radboud UMC, Nijmegen, Netherlands, ⁶Internal Medicine, Amsterdam UMC, Amsterdam, Netherlands, ⁷Internal Medicine, UMCG, Groningen, Netherlands, ⁸Internal Medicine, Erasmus MC, Rotterdam, Netherlands, ⁹Internal Medicine, Maasstad Ziekenhuis, Rotterdam, Netherlands, ¹⁰Internal Medicine, ZGT, Almelo, Netherlands

Meeting: 2021 American Transplant Congress

Abstract number: 975

Keywords: Kidney transplantation

Topic: Clinical Science » Kidney » Kidney Living Donor: Other

Session Information

Session Name: Kidney Living Donor: Other

Session Type: Poster Abstract

Session Date & Time: None. Available on demand.

Location: Virtual

*Purpose: Research has shown that a home-based educational intervention for patients with chronic kidney disease results in better knowledge and communication on all treatment options, and more living donor kidney transplantations (LDKT) compared to care-as-usual. The aims of this study were (1) to demonstrate generalizability, (2) evaluate the implementation process in terms of feasibility, fidelity and intervention costs, and (3) to assess the relationship of the intervention effects on LDKT-activity.

*Methods: Between 2016-2018, eight hospitals in the Netherlands participated in an implementation project. Patients eligible for all kidney replacement therapies (KRT) were invited to participate with their social network. Effect outcomes were KRT-knowledge and KRT-communication, and treatment choice. Feasibility, fidelity and intervention costs were assessed as part of the process evaluation. Cox-regression was used to assess the relationship of intervention effects on LDKT-activity.

*Results: 812 patients were approached, and 332 patients completed the intervention. There was a significant increase in KRT-knowledge and KRT-communication among patients and invitees. After the intervention, 129 out of 332 patients (39%) had LDKT-activity. Overall participation rate was 40.9%. Protocol adherence was high (4.61 out of 5) and intervention costs were between €2500 and €3000 per intervention. Protocol adherence, knowledge and a lower age were positively correlated with LDKT-activity.

*Conclusions: Results of the present study are comparable to the previous RCTs. These results show that the intervention can be implemented in multiple regions, while maintaining impact and quality. Results from the implementation process also support a nationwide implementation of the intervention. We recommend including home-based education in standard-care for patients with chronic kidney disease.

To cite this abstract in AMA style:

Redeker S, Ismail S, Timman R, Busschbach Jvan, Boonstra C, Brulez HF, Hollander DA, Hilbrands L, Bemelman FJ, Berger SP, Wetering Jvander, Jansen-Dekker MA, Weimar W, Massey EK. Implementation of the Kidney Team at Home Intervention: Evaluating Generalizability, Implementation Process, and Effects [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/implementation-of-the-kidney-team-at-home-intervention-evaluating-generalizability-implementation-process-and-effects/. Accessed November 21, 2024.

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