Emory Transplant Center, Emory University, Atlanta, Georgia 30322, USA.
Clin J Am Soc Nephrol. 2012 Apr;7(4):648-55. doi: 10.2215/CJN.10071011. Epub 2012 Feb 16.
In 2007, the Emory Transplant Center (ETC) kidney transplant program implemented a required educational session for ESRD patients referred for renal transplant evaluation to increase patient awareness and decrease loss to follow-up. The purpose of this study was to evaluate the association of the ETC education program on completion of the transplant evaluation process.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Incident, adult ESRD patients referred from 2005 to 2008 were included. Patient data were abstracted from medical records and linked with data from the United States Renal Data System. Evaluation completion was compared by pre- and posteducational intervention groups in binomial regression models accounting for temporal confounding.
A total of 1126 adult ESRD patients were examined in two transplant evaluation eras (75% pre- and 25% postintervention). One-year evaluation completion was higher in the post- versus preintervention group (80.4% versus 44.7%, P<0.0001). In adjusted analyses controlling for time trends, the adjusted probability of evaluation completion at 1 year was higher among the intervention versus nonintervention group (risk ratio=1.38, 95% confidence interval=1.12-1.71). The effect of the intervention was stronger among black patients and those patients living in poor neighborhoods (likelihood ratio test for interaction, P<0.05).
Standardizing transplant education may help reduce some of the racial and socioeconomic disparities observed in kidney transplantation.
2007 年，埃默里移植中心（ETC）的肾脏移植项目为接受肾脏移植评估的终末期肾病患者实施了一项必修教育课程，以提高患者的意识并减少失访率。本研究旨在评估 ETC 教育计划对完成移植评估过程的影响。
设计、地点、参与者和测量：纳入 2005 年至 2008 年期间从 ETC 转诊的成年终末期肾病患者。从病历中提取患者数据，并与美国肾脏数据系统的数据进行关联。在考虑时间混杂因素的二项式回归模型中，比较了教育前后干预组的评估完成情况。
在两个移植评估时期（75%为干预前组，25%为干预后组）共检查了 1126 名成年终末期肾病患者。干预后组的 1 年评估完成率高于干预前组（80.4%比 44.7%，P<0.0001）。在控制时间趋势的调整分析中，干预组与非干预组相比，评估完成的调整后概率更高（风险比=1.38，95%置信区间=1.12-1.71）。干预的效果在黑人患者和居住在贫困社区的患者中更强（交互作用似然比检验，P<0.05）。
标准化移植教育可能有助于减少肾脏移植中观察到的一些种族和社会经济差异。
