Opt-Out Consent at Different Levels of Attitude to Organ Donation: A Household Survey in Qatar

Abstract

Purpose Demand for an organ transplant is surpassing the number of organ donors and hence increasing waiting lists worldwide, compelling many countries to adopt an opt-out consent system for organ donation. Opt-out is used in several European countries and has increased organ registration rate. No study on this subject has been published from the gulf region to associate sociodemographic characteristics, knowledge, attitude, beliefs, and intention domains regarding an opt-out consent for organ donation. Materials and Methods A household survey was conducted between October and November 2016 using a validated questionnaire. Integer codes were assigned for qualitative data to interpret results at par with quantitative data for each domain to allow data for advanced statistical analysis. Results Of 1044 surveyed participants, 724 (69.34%) those aged 37.7±10.4 agreed to adopting an opt-out consent system of which 231 (29.4%) were Qatari citizens and 353 (48.8%) were males. Mean levels of indices such as attitude, behavioral beliefs, and intention domains to organ donation were found higher in opt out participants. After adjusting statistical significant variables, multivariate analysis showed that attitude index was associated to opt out system (OR: 16.7, 95% C.I.:10.6–26.3, p=0.001) whereas; knowledge index (OR: 0.25, 95% C.I.: 0.07–0.83, p=0.03), behavioral beliefs (OR: 0.55, 95% C.I.: 0.35–0.86, p=0.009) and intention indices (OR: 0.42, 95% C.I.: 0.20–0.87, p=0.02) were associated with opt-in system for organ donation in Qatar. Regression model was able to discriminate (AUC: 84%, 95% C.I.:81% to 87%) for opt-out consent. Future probabilities for opt-out consent were 0.80, 0.88, 0.92,0.95,0.96,0.97,0.99 and 0.993 for 0.20, 0.30, 0.40, 0.50, 0.60, 0.70, 0.80 and 0.90 attitude levels after using 200 re-samples to make traditional multivariate regression model to realistic model for the population. Conclusion The majority of the survey participants showed a good attitude but less knowledge, behavioral beliefs, and intention towards adopting an opt-out system for organ donation in Qatar.

A machine-learning approach to estimating public intentions to become a living kidney donor in England: Evidence from repeated cross-sectional survey data

“…Previous study findings have highlighted the important role played by ethnicity and religion in decisions associated with deceased organ donation ( 26 , 35 ). Our findings show that ethnic origin and religion are of less importance in the case of living kidney donation.…”

“…Variation in health systems in addition to public awareness, and cultural and ethnic differences in support for donation, mean that uptake of live donation can vary dramatically in and between countries ( 25 ). Although increasing the number of live donations remains a global health priority, interventions designed to increase live donation are poorly understood, lack an evidence base, and do not easily translate across diverse populations, so the unmet health needs and the economic burden of those awaiting transplant remain high ( 26 , 27 ).…”

“…While research continues at pace to expand the numbers of deceased organs available for transplant including organ preservation ( 28 ), public attitudes ( 29 ), family behaviors ( 30 , 31 ), professional training ( 32 ), law and policy changes ( 21 , 33 ) and awareness and understanding in and between minority and faith perspectives, ( 21 , 26 , 31 , 34 , 35 ); investigations into (changing) attitudes and motivations to become a living donor have been much more limited. In 2018, NHSBT also published a warning after living donation hit an 8-year low ( 36 ).…”