NIV Congres

Objective: Living donor kidney transplantation (LDKT) is the most successful form of renal replacement therapy (RRT). We observed a significant inequality between Western and non-Western patients in the access to LDKT. In a randomized controlled trial we investigated the effectiveness and efficacy of a home-based educational intervention to reduce this inequality by providing accessible and adequate information and to establish well-informed decision making through a guided communication with patients and individuals from their social network (invitees).

Methods: In this trial 160 patients who were on the wait list for a deceased donor kidney transplantation were urn-randomized over two conditions. The control group received standard care: hospital education (informational video and handbook) (n=80). The experimental group received standard care plus an educational intervention in their homes using multisystemic therapy (n=80). The intervention was a European translation of the programme developed by Rodrigue in the USA. A questionnaire was administered to all patients in both conditions and invitees as a baseline and post-measurement on: knowledge, risk perception, subjective norm, self-efficacy, and communication.

Results: The ratio of Western and non-Western patients in the control group was (40/40) and in the experimental group (22/43) (p= 0.074). Compared to the control group, patients who received the home-based education showed significant improvements in their overall knowledge on kidney disease and RRT’s (p< 0.001) and communicated more with their loved ones about RRT (p= 0.048). On average patients invited 5 invitees for the educational session. These invitees showed improvements in their overall knowledge (p< 0.001) and their self-efficacy regarding discussing RRT’s with the patient (p= 0.032). In addition the invitees showed a decrease in their risk perception towards LDKT (p< 0.001) and they were more willing to donate a kidney (p= 0.016) after the educational intervention.

Conclusions: We argue that these improvements in knowledge, communication, risk perception and willingness to donate support well-informed decision making regarding patient’s optimal treatment option.