Making house calls increases living donor inquiries and evaluations for blacks on the kidney transplant waiting list

Transplantation. 2014 Nov 15;98(9):979-86. doi: 10.1097/TP.0000000000000165.

Abstract

Background: Blacks receive live donor kidney transplant (LDKT) less often than patients of all other races. We evaluated the effectiveness of educational interventions in removing barriers to LDKT for blacks.

Methods: Patients were randomized to three interventions in which health educator(s) delivered an intervention to (a) the patient and his/her guests in the patient's home (house calls [HC], n=54), (b) clusters of patients and their guests in the transplant center (group based [GB], n=49), and (c) the individual patient alone in the transplant center (individual counseling [IC], n=49).

Results: At the 2-year endpoint, 15% (n=8), 8% (n=4), and 6% (n=3) of HC, GB, and IC patients, respectively, received LDKT (P=0.30). Patients in the HC group were more likely than patients in the GB and IC groups to have at least one donor inquiry (82% vs. 61% vs. 47%, P=0.001) and evaluation (65% vs. 39% vs. 27%, P<0.001). Patients in the HC group also were more likely to have higher knowledge, fewer concerns, and higher willingness to talk to others about donation 6 weeks after intervention.

Conclusions: These findings underscore the importance of including the patient's social network in LDKT education and the potential of the HC intervention to reduce racial disparity in LDKT rates.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • African Americans
  • Algorithms
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Healthcare Disparities
  • House Calls*
  • Humans
  • Kidney Failure, Chronic / ethnology*
  • Kidney Failure, Chronic / surgery
  • Kidney Transplantation / psychology*
  • Living Donors / psychology*
  • Male
  • Middle Aged
  • Patient Participation
  • Patient Satisfaction
  • Poisson Distribution
  • Regression Analysis
  • Surveys and Questionnaires
  • Time Factors
  • Tissue and Organ Procurement / methods*
  • Treatment Outcome
  • Waiting Lists