Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Nephrology
Published in: BMC Nephrology 1/2015

Open Access 01-12-2015 | Study protocol

Explore Transplant at Home: a randomized control trial of an educational intervention to increase transplant knowledge for Black and White socioeconomically disadvantaged dialysis patients

Authors: Amy D. Waterman, Anna-Michelle M. McSorley, John D. Peipert, Christina J. Goalby, Leanne J. Peace, Patricia A. Lutz, Jessica L. Thein

Published in: BMC Nephrology | Issue 1/2015

Login to get access

Abstract

Background

Compared to others, dialysis patients who are socioeconomically disadvantaged or Black are less likely to receive education about deceased donor kidney transplant (DDKT) and living donor kidney transplant (LDKT) before they reach transplant centers, often due to limited availability of transplant education within dialysis centers. Since these patients are often less knowledgeable or ready to pursue transplant, educational content must be simplified, made culturally sensitive, and presented gradually across multiple sessions to increase learning and honor where they are in their decision-making about transplant. The Explore Transplant at Home (ETH) program was developed to help patients learn more about DDKT and LDKT at home, with and without telephone conversations with an educator.

Methods and Study Design

In this randomized controlled trial (RCT), 540 low-income Black and White dialysis patients with household incomes at or below 250 % of the federal poverty line, some of whom receive financial assistance from the Missouri Kidney Program, will be randomly assigned to one of three education conditions: (1) standard-of-care transplant education provided by the dialysis center, (2) patient-guided ETH (ETH-PG), and (3) health educator-guided ETH (ETH-EG). Patients in the standard-of-care condition will only receive education provided in their dialysis centers. Those in the two ETH conditions will receive four video and print modules delivered over an 8 month period by mail, with the option of receiving supplementary text messages weekly. In addition, patients in the ETH-EG condition will participate in multiple telephonic educational sessions with a health educator. Changes in transplant knowledge, decisional balance, self-efficacy, and informed decision making will be captured with surveys administered before and after the ETH education.

Discussion

At the conclusion of this RCT, we will have determined whether an education program administered to socioeconomically disadvantaged dialysis patients, over several months directly in their homes, can help more individuals learn about the options of DDKT and LDKT. We also will be able to examine the efficacy of different educational delivery approaches to further understand whether the addition of a telephone educator is necessary for increasing transplant knowledge.

Trial Registration

ClinicalTrials.gov, NCT02268682
Literature
1.
United States Renal Data System. 2014 Annual Data Report: Epidemiology of Kidney Disease in the United States. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2014.
2.
Mange KC, Joffe MM, Feldman HI. Effect of the use or nonuse of long-term dialysis on the subsequent survival of renal transplants from living donors. N Engl J Med. 2001;344(10):726–31.PubMed
3.
Neipp M, Karavul B, Jackobs S, Meyer zu Vilsendorf A, Richter N, Becker T, et al. Quality of life in adult transplant recipients more than 15 years after kidney transplantation. Transplantation. 2006;81(12):1640–4.PubMed
4.
Centers for Medicare & Medicaid Services (CMS), Department of Health and Human Services. Medicare and Medicaid programs; conditions for coverage for end-stage renal disease facilities. Final rule. Fed Regist. 2008;73(73):20369–484.
5.
Bleyer A: Prevention of sudden cardiac death in dialysis patients: A nephrologist's perspective. Dialysis & Transplantation 2008;37(4):124–129.
6.
Brunkhorst R, Lufft V, Dannenberg B, Kliem V, Tusch G, Pichlmayr R. Improved survival in patients with type 1 diabetes mellitus after renal transplantation compared with hemodialysis: a case–control study. Transplantation. 2003;76(1):115–9.PubMed
7.
Meier-Kriesche HU, Port FK, Ojo AO, Rudich SM, Hanson JA, Cibrik DM, et al. Effect of waiting time on renal transplant outcome. Kidney Int. 2000;58(3):1311–7.PubMed
8.
Waterman AD, Peipert JD, Hyland SS, McCabe MS, Schenk EA, Liu J. Modifiable patient characteristics and racial disparities in evaluation completion and living donor transplant. Clin J Am Soc Nephrol. 2013;8:995–1002.PubMedPubMedCentral
9.
Kutner NG, Zhang R, Huang Y, Johansen KL. Impact of race on predialysis discussions and kidney transplant preemptive wait-listing. Am J Nephrol. 2012;35(4):305–11.PubMedPubMedCentral
10.
Johns TS, Estrella MM, Crews DC, Appel LJ, Anderson CA, Ephraim PL, et al. Neighborhood socioeconomic status, race, and mortality in young adult dialysis patients. J Am Soc Nephrol. 2014;25(11):2649–57.PubMedPubMedCentral
11.
Hardinger KL, Hutcherson T, Preston D, Murillo D. Influence of pill burden and drug cost on renal function after transplantation. Pharmacotherapy. 2012;32(5):427–32.PubMed
12.
McGee J, Jackson NR, Slakey DP. Disability and kidney transplantation in the United States. Clin Transpl. 2012;26(3):377–81.
13.
Chenitz KB, Fernando M, Shea JA. In-center hemodialysis attendance: patient perceptions of risks, barriers, and recommendations. Hemodial Int. 2014;18(2):364–73.PubMed
14.
Chan KE, Thadhani RI, Maddux FW. Adherence barriers to chronic dialysis in the United States. J Am Soc Nephrol. 2014;25(11):2642–8.PubMedPubMedCentral
15.
Harley KT, Streja E, Rhee CM, Molnar MZ, Kovesdy CP, Amin AN, et al. Nephrologist caseload and hemodialysis patient survival in an urban cohort. J Am Soc Nephrol. 2013;24:1–10.
16.
Balhara KS, Kucirka LM, Jaar BG, Segev DL. Disparities in provision of transplant education by profit status of the dialysis center. Am J Transplant. 2012;12(11):3104–10.PubMed
17.
Patzer RE, Plantinga L, Krisher J, Pastan SO. Dialysis facility and network factors associated with low kidney transplantation rates among United States dialysis facilities. Am J Transplant. 2014;14(7):1562–72.PubMedPubMedCentral
18.
Waterman AD, Goalby C, Hyland SS, McCabe M, Dinkel KM (2012) Transplant Education Practices and Attitudes in Dialysis Centers: Dialysis Leadership Weighs In. J Nephrol Therapeutic S4:007. doi:10.​4172/​2161-0959.​S4-007.
19.
Waterman A, Hyland S, Stanley SL, Barrett AC, Millinger R: Improving education increases dialysis patients' pursuit of transplant: Explore Transplant RCT findings. In: American Transplant Congress: May 30-June 3 2009; Boston, MA: American journal of transplantation; 2009: 360
20.
Waterman AD, Goalby C, Hyland S: Dialysis providers ability to educate patients about transplant: good education partners? In: American Transplant Congress: May 30-June 3 2009; Boston, MA; 2009
21.
LaPointe RD, Hays R, Baliga P, Cohen DJ, Cooper M, Danovitch GM, et al. Consensus conference on best practices in live kidney donation: recommendations to optimize education, access, and care. Am J Transplant. 2015;15(4):912–22.
22.
Boulware LE, Hill-Briggs F, Kraus ES, Melancon JK, Falcone B, Ephraim PL, et al. Effectiveness of educational and social worker interventions to activate patients' discussion and pursuit of preemptive living donor kidney transplantation: a randomized controlled trial. Am J Kidney Dis. 2012;61(3):476–86.PubMedPubMedCentral
23.
Schmittdiel JA, Brown SD, Neugebauer R, Adams SR, Adams AS, Wiley D, et al. Health-plan and employer-based wellness programs to reduce diabetes risk: the Kaiser permanente Northern California NEXT-D Study. Prev Chronic Dis. 2013;10:E15.PubMedPubMedCentral
24.
Rodrigue JR, Paek MJ, Egbuna O, Waterman AD, Schold JD, Pavlakis M, et al. Making house calls increases living donor inquiries and evaluations for blacks on the kidney transplant waiting list. Transplantation. 2014;98(9):979–86.PubMedPubMedCentral
25.
Cole-Lewis H, Kershaw T. Text messaging as a tool for behavior change in disease prevention and management. Epidemiol Rev. 2010;32(1):56–69.PubMedPubMedCentral
26.
Lim MS, Hocking JS, Hellard ME, Aitken CK. SMS STI: a review of the uses of mobile phone text messaging in sexual health. Int J STD AIDS. 2008;19(5):287–90.PubMed
27.
Chen RA, Scott S, Mattern WD, Mohini R, Nissenson AR. The case for disease management in chronic kidney disease. DM. 2006;9(2):86–92.PubMed
28.
29.
30.
Glanz K, Bishop DB. The role of behavioral science theory in development and implementation of public health interventions. Annu Rev Public Health. 2010;31:399–418.PubMed
31.
Prochaska JO, Redding CA, Evers KE. The transtheoretical model and stages of change. In: Glanz K, Rimer B, Lewis F, editors. Health Behavior and Health Education. 3rd ed. San Francisco, CA: Jossey-Bass; 2002. p. 99–120.
32.
Prochaska JO. Decision making in the transtheoretical model of behavior change. Med Decis Making. 2008;28(6):845–9.PubMed
33.
Prochaska JO, DiClemente CC. Stages and processes of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol. 1983;51(3):390–5.PubMed
34.
Prochaska JO, DiClemente CC, Norcross JC. In search of how people change: applications to addictive behaviors. Am Psychol. 1992;47(9):1102–14.PubMed
35.
Prochaska JO, DiClemente CC, Velicer WF, Rossi JS. Standardized, individualized, interactive, and personalized self-help programs for smoking cessation. Health Psychol. 1993;12(5):399–405.PubMed
36.
Prochaska JO, Norcross JC. Stages of change. Psychother Theory Res Pract Train. 2001;38(4):443–8.
37.
Prochaska JO, Velicer WF, Redding C, Rossi JS, Goldstein M, DePue J, et al. Stage-based expert systems to guide a population of primary care patients to quit smoking, eat healthier, prevent skin cancer, and receive regular mammograms. Prev Med. 2005;41(2):406–16.PubMed
38.
Robbins ML, Levesque DA, Redding CA, Johnson JL, Prochaska JO, Rohr MS, et al. Assessing family members’ motivational readiness and decision making for consenting to cadaveric organ donation. J Health Psychol. 2001;6(5):523–35.PubMed
39.
Hall KL, Robbins ML, Paiva A, Knott JE, Harris L, Mattice B. Donation intentions among African American college students: decisional balance and self-efficacy measures. J Behav Med. 2007;30(6):483–95.PubMed
40.
Waterman AD, Brown J, Witten B, Goodnight V, Mallery C, Schenk E, Goalby C, Frazier L, Peace L, Hyland SS: Preemptive Transplant Knowledge and Decision-Making: Impact of a Community Chronic Kidney Disease Education Class. In: National Kidney Foundation Spring Clinical Meetings. National Harbor, MD; 2012
41.
United States Census Bureau: Text-Messaging Soars. In: Census Bureau Releases 2010 Statistical Abstract Depicting the State of Our Nation. 2009.
42.
United States Census Bureau: Homes With Cell Phones Nearly Double in First Half of Decade. 2014. Washington, DC: United States Census Bureau; 2009..
43.
Vervloet M, van Dijk L, Santen-Reestman J, van Vlijmen B, van Wingerden P, Bouvy ML, et al. SMS reminders improve adherence to oral medication in type 2 diabetes patients who are real time electronically monitored. J Med Inform. 2012;81(9):594–604.
44.
Leong KC, Chen WS, Leong KW, Mastura I, Mimi O, Sheikh MA, et al. The use of text messaging to improve attendance in primary care: a randomized controlled trial. Fam Pract. 2006;23(6):699–705.PubMed
45.
Siebens J: Extended Measures of Well-Being: Living Conditions in the United States: 2011. Washington DC: United States Census Bureau; 2013. 70–136.
46.
Smith A: Americans and Their Cell Phones. In. Washington, DC: Pew Internet and American Life Project; 2011:1–19
47.
48.
Hekkers V. Insurance reimbursement. Case Manager. 2005;16(3):34–5.
49.
O’Connor AM. Validation of a decisional conflict scale. Med Decis Making. 1995;15(1):25–30.PubMed
50.
Waterman A, Robbins M, Paiva A, Hyland SS. Kidney patients' intention to receive a deceased donor transplant: Development of stage of change, decisional balance, and self-efficacy measures. J Health Psychol. 2010;15(3):436–45.PubMedPubMedCentral
51.
Waterman AD, Robbins ML, Paiva AL, Peipert JD, Davis LA, Hyland SS, et al. Measuring kidney patients’ motivation to pursue living donor kidney transplant: development of stage of change, decisional balance and self-efficacy measures. J Health Psychol. 2015;20(2):210–21.PubMed
52.
Guyatt GH, Feeny DH, Patrick DL. Measuring health-related quality of life. Ann Intern Med. 1993;118(8):622–9.PubMed
53.
LaVeist TA, Isaac LA, Williams KP. Mistrust of health care organizations is associated with underutilization of health services. Health Serv Res. 2009;44(6):2093–105.PubMedPubMedCentral
54.
Boulware LE, Ratner LE, Cooper LA, Sosa JA, LaVeist TA, Powe NR. Understanding disparities in donor behavior: race and gender differences in willingness to donate blood and cadaveric organs. Med Care. 2002;40(2):85–95.PubMed
55.
National Institutes of Health Centers for Population Health and Health Disparities: Core Measures Database. Edited by Centers for Population Health and Health Disparities. Bethesda, MD 2012.
56.
Gehlert S: University of Chicago CIHDR Women’s Community Study Questionnaire. Center for Interdisciplinary Health Disparities Research, University of Chicago 2008.
57.
Chew LD, Griffin JM, Partin MR, Noorbaloochi S, Grill JP, Snyder A, et al. Validation of screening questions for limited health literacy in a large VA outpatient population. J Gen Intern Med. 2008;23(5):561–6.PubMedPubMedCentral
58.
Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377–81.PubMed
59.
Murray DM. Design and Analysis of Group-Randomized Control Trials. Oxford: Oxford University Press; 1998.
60.
Rubin DB. Multiple imputation for nonresponse in surveys. New York: John Wiley & Sons, Inc.; 1987.
61.
Nordio M, Limido A, Maggiore U, Nichelatti M, Postorino M, Quintaliani G. Survival in patients treated by long-term dialysis compared with the general population. Am J Kidney Dis. 2012;59(6):819–28.PubMed
62.
Sullivan C, Leon JB, Sayre SS, Marbury M, Ivers M, Pencak JA, et al. Impact of navigators on completion of steps in the kidney transplant process: a randomized, controlled trial. Clin J Am Soc Nephrol. 2012;7(10):1639–45.PubMedPubMedCentral
63.
Gordon EJ, Mullee JO, Ramirez DI, MacLean J, Olivero M, Feinglass J, et al. Hispanic/Latino concerns about living kidney donation: a focus group study. Prog Transplant. 2014;24(2):152–62.PubMed
64.
Gordon EJ, Reddy E, Gil S, Feinglass J, Rodde J, Abecassis MM, et al. Culturally competent transplant program improves Hispanics’ knowledge and attitudes about live kidney donation and transplant. Prog Transplant. 2014;24:56–68.PubMed
Metadata
Title
Explore Transplant at Home: a randomized control trial of an educational intervention to increase transplant knowledge for Black and White socioeconomically disadvantaged dialysis patients
Authors
Amy D. Waterman
Anna-Michelle M. McSorley
John D. Peipert
Christina J. Goalby
Leanne J. Peace
Patricia A. Lutz
Jessica L. Thein
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Nephrology / Issue 1/2015
Electronic ISSN: 1471-2369
DOI
https://doi.org/10.1186/s12882-015-0143-0

Other articles of this Issue 1/2015

BMC Nephrology 1/2015 Go to the issue

Research article

TWEAK/Fn14 system and crescent formation in IgA nephropathy

Research article

A global overview of renal registries: a systematic review

Study protocol

A protocol for the identification and validation of novel genetic causes of kidney disease

Research article

Association of frailty with endothelial dysfunction and its possible impact on negative outcomes in Brazilian predialysis patients with chronic kidney disease

Research article

Hyperphosphatemia as an independent risk factor for coronary artery calcification progression in peritoneal dialysis patients

Research article

A vital role for Angptl3 in the PAN-induced podocyte loss by affecting detachment and apoptosis in vitro
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits