Impact of navigators on completion of steps in the kidney transplant process: a randomized, controlled trial.
Clin J Am Soc Nephrol
; 7(10): 1639-45, 2012 Oct.
Article
in En
| MEDLINE
| ID: mdl-22798540
ABSTRACT
BACKGROUND AND OBJECTIVES:
Many patients with ESRD, particularly minorities and women, face barriers in completing the steps required to obtain a transplant. These eight sequential steps are as follows medical suitability, interest in transplant, referral to a transplant center, first visit to center, transplant workup, successful candidate, waiting list or identify living donor, and receive transplant. This study sought to determine the effect of navigators on completion of steps. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Cluster randomized, controlled trial at 23 Ohio hemodialysis facilities. One hundred sixty-seven patients were recruited between January 2009 and August 2009 and were followed for up to 24 months or until study end in February 2011. Trained kidney transplant recipients met monthly with intervention participants (n=92), determined their step in the transplant process, and provided tailored information and assistance in completing the step. Control participants (n=75) continued to receive usual care. The primary outcome was the number of transplant process steps completed.RESULTS:
Starting step did not significantly differ between the two groups. By the end of the trial, intervention participants completed more than twice as many steps as control participants (3.5 versus 1.6 steps; difference, 1.9 steps; 95% confidence interval, 1.3-2.5 steps). The effect of the intervention on step completion was similar across race and sex subgroups.CONCLUSIONS:
Use of trained transplant recipients as navigators resulted in increased completion of transplant process steps.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Peer Group
/
Patient Acceptance of Health Care
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Kidney Transplantation
/
Patient Navigation
/
Kidney Failure, Chronic
Type of study:
Clinical_trials
/
Etiology_studies
/
Prognostic_studies
Limits:
Adolescent
/
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
America do norte
Language:
En
Journal:
Clin J Am Soc Nephrol
Journal subject:
NEFROLOGIA
Year:
2012
Document type:
Article
Affiliation country:
United States