Effectiveness of informational decision aids and a live donor financial assistance program on pursuit of live kidney transplants in African American hemodialysis patients.

Journal Article (Journal Article;Multicenter Study)

BACKGROUND: African Americans have persistently poor access to living donor kidney transplants (LDKT). We conducted a small randomized trial to provide preliminary evidence of the effect of informational decision support and donor financial assistance interventions on African American hemodialysis patients' pursuit of LDKT. METHODS: Study participants were randomly assigned to receive (1) Usual Care; (2) the Providing Resources to Enhance African American Patients' Readiness to Make Decisions about Kidney Disease (PREPARED); or (3) PREPARED plus a living kidney donor financial assistance program. Our primary outcome was patients' actions to pursue LDKT (discussions with family, friends, or doctor; initiation or completion of the recipient LDKT medical evaluation; or identification of a donor). We also measured participants' attitudes, concerns, and perceptions of interventions' usefulness. RESULTS: Of 329 screened, 92 patients were eligible and randomized to Usual Care (n = 31), PREPARED (n = 30), or PREPARED plus financial assistance (n = 31). Most participants reported interventions helped their decision making about renal replacement treatments (62%). However there were no statistically significant improvements in LDKT actions among groups over 6 months. Further, no participants utilized the living donor financial assistance benefit. CONCLUSIONS: Findings suggest these interventions may need to be paired with personal support or navigation services to overcome key communication, logistical, and financial barriers to LDKT. TRIAL REGISTRATION: ClinicalTrials.gov [ NCT01439516 ] [August 31, 2011].

Full Text

Duke Authors

Cited Authors

  • Boulware, LE; Ephraim, PL; Ameling, J; Lewis-Boyer, L; Rabb, H; Greer, RC; Crews, DC; Jaar, BG; Auguste, P; Purnell, TS; Lamprea-Monteleagre, JA; Olufade, T; Gimenez, L; Cook, C; Campbell, T; Woodall, A; Ramamurthi, H; Davenport, CA; Choudhury, KR; Weir, MR; Hanes, DS; Wang, N-Y; Vilme, H; Powe, NR

Published Date

  • May 3, 2018

Published In

Volume / Issue

  • 19 / 1

Start / End Page

  • 107 -

PubMed ID

  • 29724177

Pubmed Central ID

  • PMC5934897

Electronic International Standard Serial Number (EISSN)

  • 1471-2369

Digital Object Identifier (DOI)

  • 10.1186/s12882-018-0901-x


  • eng

Conference Location

  • England