Decision aids for Organ transplant candidates

Gordon, Elisa J.; Ison, Michael G.

doi:10.1002/lt.23908

Cited by 11 publications

(9 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Non-neutral decision aids 11 designed to encourage patients to accept IRD organs 15 can compromise informed consent. 51 Inform Me’s neutral design can allay policy-makers’ concerns that patients are well-informed about IRD organs given the potential for infectious disease transmission. 52,53 …”

Section: Discussionmentioning

confidence: 99%

Effect of a Mobile Web App on Kidney Transplant Candidates' Knowledge About Increased Risk Donor Kidneys

Gordon¹,

Sohn

Chang

et al. 2017

Transplantation

Self Cite

View full text Add to dashboard Cite

Background Kidney transplant candidates (KTCs) must provide informed consent to accept kidneys from increased risk donors (IRD), but poorly understand them. We conducted a multisite, randomized controlled trial to evaluate the efficacy of a mobile web application, Inform Me, for increasing knowledge about IRDs. Methods KTCs undergoing transplant evaluation at 2 transplant centers were randomized to use Inform Me after routine transplant education (intervention) or routine transplant education alone (control). Computer adaptive learning method reinforced learning by embedding educational material, and initial (Test 1) and additional test questions (Test 2) into each chapter. Knowledge (primary outcome) was assessed in person after education (Tests 1 and 2), and 1-week later by telephone (Test 3). Controls did not receive Test 2. Willingness to accept an IRD kidney (secondary outcome) was assessed after Tests 1 and 3. Linear regression Test 1 knowledge scores were used to test the significance of Inform Me exposure after controlling for covariates. Multiple imputation was used for intention-to-treat analysis. Results Two hundred-eighty-eight KTCs participated. Intervention participants had higher Test 1 knowledge scores (mean difference=6.61; 95% CI, 5.37–7.86) than control participants, representing a 44% higher score than control participants’ scores. Intervention participants’ knowledge scores increased with educational reinforcement (Test 2) compared to control arm Test 1 scores (mean difference=9.50; 95% CI, 8.27–10.73). After 1 week, intervention participants’ knowledge remained greater than controls’ (mean difference=3.63; 95% CI, 2.49–4.78) (Test 3). Willingness to accept an IRD kidney did not differ between study arms at Tests 1 and 3. Conclusion Inform Me use was associated with greater KTC knowledge about IRD kidneys above routine transplant education alone.

show abstract

Section: Discussionmentioning

confidence: 99%

Effect of a Mobile Web App on Kidney Transplant Candidates' Knowledge About Increased Risk Donor Kidneys

Gordon¹,

Sohn

Chang

et al. 2017

Transplantation

Self Cite

View full text Add to dashboard Cite

show abstract

“…Ensuring that these interventions are culturally competent enhances efficacy 32 and may help combat the effects of physician distrust. Any intervention or decision aid must be careful to remain neutral in order to avoid compromising informed consent 33 …”

Section: Discussionmentioning

confidence: 99%

“…Any intervention or decision aid must be careful to remain neutral in order to avoid compromising informed consent. 33 Knowledge assessments and educational interventions should take care to focus on high-impact beliefs. In our review, perceptions of high cure rates, shorter waitlist times, and higher organ quality seemed to have the highest impact on organ acceptance.…”

Section: Discussionmentioning

confidence: 99%

Clinician and patient attitudes toward use of organs from hepatitis C viremic donors and their impact on acceptance: A contemporary review

Fleetwood

Maher

Satish

et al. 2021

Clinical Transplantation

View full text Add to dashboard Cite

Background The use of Hepatitis C (HCV) NAT positive allografts remains unusual and is clustered at few centers. We conducted a contemporary literature review to assess whether patient and clinician attitudes toward viremic organs impact acceptance. Methods Databases including PubMed, MEDLINE, and SCOPUS databases were reviewed to identify studies focused on evaluating patient and provider perceptions of HCV NAT positive organ use within the DAA era (January 2015–April 2021). Search included MeSH terms related to Hepatitis C, transplantation, and patient and clinician attitudes. Two investigators extracted study characteristics including information on willingness to accept viremic organs, HCV‐specific outcomes knowledge, HCV‐specific concerns, and factors that contributed to acceptance or non‐acceptance. Results Eight studies met all inclusion criteria. These included three pretransplant patient‐directed studies, two post‐transplant patient‐directed studies, one pre‐ and post‐transplant patient‐directed study, and two clinician‐directed studies. Common themes identified were concerns regarding HCV cure rates, viremic organ quality, DAA cost, stigma, and the possibility of HCV transmission to household members. The perception of decreased waitlist time was associated with viremic organ acceptance. Physician trust played a mixed role in acceptance patterns. Conclusions Knowledge of high cure rates, shorter waitlist times, and higher organ quality appear to have the highest impact on organ acceptance.

show abstract

“…Therefore, the most crucial information should be delivered more effectively, such as through the development of decision aids. 30,31 Layering information in decision aids from basic to more complex in-depth explanations could address both patients' information preferences for more or less information while also satisfying clinicians' obligations to disclose risk information. Health information technology interventions can enhance informed consent by improving patients' objective comprehension of medical procedures, decreasing patients' anxiety levels, and increasing satisfaction with care.…”

Section: Discussionmentioning

confidence: 99%

Live liver donors’ information needs: A qualitative study of practical implications for informed consent

Gordon

Mullee

Skaro

et al. 2016

Surgery

Self Cite

View full text Add to dashboard Cite

Background As live donor liver transplantation is increasingly used to expand the donor pool, concerns remain regarding ensuring live liver donors' informed consent. This study assessed donors' information preferences and perceptions of informed consent. Methods Cognitive interviews were conducted with donors by telephone about how knowledge items in a new survey instrument were material to informed consent, between November 2011 and April 2012. Thematic analysis was used to analyze qualitative data until reaching saturation. Results Twenty-nine liver donors participated (85% participation rate). Donors commonly reported being unable to understand or retain much information disclosed during education. Donors preferred information about major donation risks, e.g., death, and minor risks that would likely affect their daily lives, e.g., wound infection. Donors expressed less interest in information about their rights, confidentiality, or the medical procedure. Donors' preferences varied regarding statistical information. Many perceived the disclosure of risk information to be excessive, and rationalized risks believed to be uncommon or not serious. Donors were disappointed by the brevity of the post-donation hospital stay. Conclusions Our findings suggest that the complexity and volume of disclosed information during evaluation was difficult for donors to adequately comprehend. Donors' lack of appreciation for the seriousness of complications may undermine their ability to provide informed consent. Future research should develop effective information delivery methods to enhance informed consent.

show abstract

Decision aids for Organ transplant candidates

Cited by 11 publications

References 18 publications

Effect of a Mobile Web App on Kidney Transplant Candidates' Knowledge About Increased Risk Donor Kidneys

Effect of a Mobile Web App on Kidney Transplant Candidates' Knowledge About Increased Risk Donor Kidneys

Clinician and patient attitudes toward use of organs from hepatitis C viremic donors and their impact on acceptance: A contemporary review

Live liver donors’ information needs: A qualitative study of practical implications for informed consent

Contact Info

Product

Resources

About