Providing Resources to Enhance African American Patients' Readiness to Make Decisions About Kidney Disease (PREPARED) Study
| Status: | Completed |
|---|---|
| Conditions: | Renal Impairment / Chronic Kidney Disease |
| Therapuetic Areas: | Nephrology / Urology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 8/23/2018 |
| Start Date: | August 2012 |
| End Date: | April 2014 |
Information and Financial Interventions for Kidney Donation in African Americans
African Americans are less likely than Whites to receive kidney transplants, despite their
being more than two-fold as likely as Whites to develop end stage renal disease (ESRD).
Living related kidney donation (LD) offers patients an opportunity to bypass many barriers to
receipt of deceased kidney transplants (e.g. waiting lists and immunological
incompatibility), but minorities are less likely to receive living related kidney transplants
(LRT). Evidence suggests African Americans may not discuss LD/LRT with their families or
physicians at optimal rates, and thus may not have adequate information to initiate or
participate in shared decision-making regarding LD/LRT. African Americans may also have
financial concerns regarding convalescence and out of pocket expenses related to LD/LRT,
another barrier impeding LD/LRT.
The primary goals of this study are to overcome these important barriers by enhancing ethnic
minorities' consideration of LD/LRT through the promotion of shared decision-making regarding
LD/LRT and provision of financial assistance for out of pocket expenses. The investigators
specific aims are: a) to develop culturally sensitive informational (audiovisual) and
financial interventions and b) to perform a randomized controlled trial to assess their
effectiveness in increasing pursuit of LD/LRT among African American patients with ESRD and
their families. The investigators hypothesize: (1) Patients and families who view
informational materials designed to promote shared decision-making regarding LD/LRT will be
more likely than patients and families not viewing these materials to discuss LD/LRT with
family and with health care professionals. Patients and families viewing such informational
materials will also be more likely than those not viewing these materials to pursue and
complete the LD/LRT process and (2) patients and their families who are offered the
intervention to promote shared decision-making plus a financial assistance intervention for
potential live kidney donors will be more likely than patients and families not offered both
interventions to pursue and complete the LD/LRT process.
being more than two-fold as likely as Whites to develop end stage renal disease (ESRD).
Living related kidney donation (LD) offers patients an opportunity to bypass many barriers to
receipt of deceased kidney transplants (e.g. waiting lists and immunological
incompatibility), but minorities are less likely to receive living related kidney transplants
(LRT). Evidence suggests African Americans may not discuss LD/LRT with their families or
physicians at optimal rates, and thus may not have adequate information to initiate or
participate in shared decision-making regarding LD/LRT. African Americans may also have
financial concerns regarding convalescence and out of pocket expenses related to LD/LRT,
another barrier impeding LD/LRT.
The primary goals of this study are to overcome these important barriers by enhancing ethnic
minorities' consideration of LD/LRT through the promotion of shared decision-making regarding
LD/LRT and provision of financial assistance for out of pocket expenses. The investigators
specific aims are: a) to develop culturally sensitive informational (audiovisual) and
financial interventions and b) to perform a randomized controlled trial to assess their
effectiveness in increasing pursuit of LD/LRT among African American patients with ESRD and
their families. The investigators hypothesize: (1) Patients and families who view
informational materials designed to promote shared decision-making regarding LD/LRT will be
more likely than patients and families not viewing these materials to discuss LD/LRT with
family and with health care professionals. Patients and families viewing such informational
materials will also be more likely than those not viewing these materials to pursue and
complete the LD/LRT process and (2) patients and their families who are offered the
intervention to promote shared decision-making plus a financial assistance intervention for
potential live kidney donors will be more likely than patients and families not offered both
interventions to pursue and complete the LD/LRT process.
The investigators will enroll 210 adult African American patients with new-onset ESRD from
dialysis facilities in the Baltimore metropolitan area and measure their initial commitment
to pursue LD/LRT. Participants will then be randomized to one of three groups: 1)
informational intervention alone (PREPARED education), 2) informational intervention plus
living donor financial assistance program (PREPARED plus financial assistance), and 3) no
intervention (Usual Care). The investigators will follow participants for up to 6 months for
progression in their commitment to LD/LRT.
dialysis facilities in the Baltimore metropolitan area and measure their initial commitment
to pursue LD/LRT. Participants will then be randomized to one of three groups: 1)
informational intervention alone (PREPARED education), 2) informational intervention plus
living donor financial assistance program (PREPARED plus financial assistance), and 3) no
intervention (Usual Care). The investigators will follow participants for up to 6 months for
progression in their commitment to LD/LRT.
Inclusion Criteria:
- Age 18 or older
- End-stage renal disease (ESRD) receiving hemodialysis for less than 2 years
- Self-reported as African-American
- English Speaking
Exclusion Criteria:
- Dementia
- Prior Kidney Transplant
- Non-English Speaking
- Cancer within 2 years prior to recruitment date
- Stage 4 Congestive Heart Failure
- End Stage Liver Disease
- Unstable Coronary Artery Disease
- Pulmonary Hypertension
- Severe Peripheral Vascular Disease
- Chronic Debilitating Infections
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