Patient-Reported Barriers to the Prekidney Transplant Evaluation in an At-Risk Population in the United States.

Authors:
Mark B Lockwood
Mark B Lockwood
University of Illinois at Chicago College of Nursing
Chicago | United States
Milda R Saunders
Milda R Saunders
Section of Hospital Medicine
Chicago | United States
Patrick N Cunningham
Patrick N Cunningham
University of Chicago
Michelle A Josephson
Michelle A Josephson
University of Chicago
Chicago | United States
Yolanda T Becker
Yolanda T Becker
University of Wisconsin
United States

Prog Transplant 2017 Jun 27;27(2):131-138. Epub 2017 Mar 27.

6 Oregon Health and Science University, School of Nursing.

Background: Despite our knowledge of barriers to the early stages of the transplant process, we have limited insight into patient-reported barriers to the prekidney transplant medical evaluation in populations largely at-risk for evaluation failure.

Methods: One-hundred consecutive adults were enrolled at an urban, Midwestern transplant center. Demographic, clinical, and quality of life data were collected prior to patients visit with a transplant surgeon/nephrologist (evaluation begins). Patient-reported barriers to evaluation completion were collected using the Subjective Barriers Questionnaire 90-days after the initial medical evaluation appointment (evaluation ends), our center targeted goal for transplant work-up completion.

Results: At 90 days, 40% of participants had not completed the transplant evaluation. Five barrier categories were created from the 85 responses to the Subjective Barriers Questionnaire. Patient-reported barriers included poor communication, physical health, socioeconomics, psychosocial influences, and access to care. In addition, determinants for successful evaluation completion included being of white race, higher income, free of dialysis, a lower comorbid burden, and reporting higher scores on the Kidney Disease Quality of Life subscale role-emotional.

Conclusion: Poor communication between patients and providers, and among providers, was the most prominent patient-reported barrier identified. Barriers were more prominent in marginalized groups such as ethnic minorities and people with low income. Understanding the prevalence of patient-reported barriers may aid in the development of patient-centered interventions to improve completion rates.

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http://dx.doi.org/10.1177/1526924817699957DOI Listing

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June 2017
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References

(Supplied by CrossRef)
Article in Nephrol Nurs J
Lockwood MB et al.
Nephrol Nurs J 2016

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