视频对基层医疗患者器官捐赠同意率的影响：一项随机对照试验。
Effects of a Video on Organ Donation Consent Among Primary Care Patients: A Randomized Controlled Trial.
作者信息
Thornton J Daryl, Sullivan Catherine, Albert Jeffrey M, Cedeño Maria, Patrick Bridget, Pencak Julie, Wong Kristine A, Allen Margaret D, Kimble Linda, Mekesa Heather, Bowen Gordon, Sehgal Ashwini R
机构信息
Center for Reducing Health Disparities, MetroHealth Campus of Case Western Reserve University, 2500 MetroHealth Drive, Rammelkamp R209A, Cleveland, OH, USA.
Division of Pulmonary, Critical Care, and Sleep Medicine, MetroHealth Campus of Case Western Reserve University, Cleveland, OH, USA.
出版信息
J Gen Intern Med. 2016 Aug;31(8):832-9. doi: 10.1007/s11606-016-3630-5.
BACKGROUND
Low organ donation rates remain a major barrier to organ transplantation.
OBJECTIVE
We aimed to determine the effect of a video and patient cueing on organ donation consent among patients meeting with their primary care provider.
DESIGN
This was a randomized controlled trial between February 2013 and May 2014.
SETTING
The waiting rooms of 18 primary care clinics of a medical system in Cuyahoga County, Ohio.
PATIENTS
The study included 915 patients over 15.5 years of age who had not previously consented to organ donation.
INTERVENTIONS
Just prior to their clinical encounter, intervention patients (n = 456) watched a 5-minute organ donation video on iPads and then choose a question regarding organ donation to ask their provider. Control patients (n = 459) visited their provider per usual routine.
MAIN MEASURES
The primary outcome was the proportion of patients who consented for organ donation. Secondary outcomes included the proportion of patients who discussed organ donation with their provider and the proportion who were satisfied with the time spent with their provider during the clinical encounter.
KEY RESULTS
Intervention patients were more likely than control patients to consent to donate organs (22 % vs. 15 %, OR 1.50, 95%CI 1.10-2.13). Intervention patients were also more likely to have donation discussions with their provider (77 % vs. 18 %, OR 15.1, 95%CI 11.1-20.6). Intervention and control patients were similarly satisfied with the time they spent with their provider (83 % vs. 86 %, OR 0.87, 95%CI 0.61-1.25).
LIMITATION
How the observed increases in organ donation consent might translate into a greater organ supply is unclear.
CONCLUSION
Watching a brief video regarding organ donation and being cued to ask a primary care provider a question about donation resulted in more organ donation discussions and an increase in organ donation consent. Satisfaction with the time spent during the clinical encounter was not affected.
TRIAL REGISTRATION
clinicaltrials.gov Identifier: NCT01697137.
背景
器官捐献率低仍然是器官移植的主要障碍。
目的
我们旨在确定视频和患者提示对与初级保健提供者会面的患者器官捐献同意率的影响。
设计
这是一项2013年2月至2014年5月间的随机对照试验。
地点
俄亥俄州凯霍加县一个医疗系统的18家初级保健诊所的候诊室。
患者
该研究纳入了915名年龄超过15.5岁且此前未同意器官捐献的患者。
干预措施
在临床就诊前，干预组患者（n = 456）在iPad上观看一段5分钟的器官捐献视频，然后选择一个关于器官捐献的问题询问其提供者。对照组患者（n = 459）按常规流程就诊。
主要测量指标
主要结局是同意器官捐献的患者比例。次要结局包括与提供者讨论器官捐献的患者比例以及对临床就诊期间与提供者相处时间感到满意的患者比例。
关键结果
干预组患者比对照组患者更有可能同意捐献器官（22%对15%，OR 1.50，95%CI 1.10 - 2.13）。干预组患者也更有可能与提供者进行捐献讨论（77%对18%，OR 15.1，95%CI 11.1 - 20.6）。干预组和对照组患者对与提供者相处时间的满意度相似（83%对86%，OR 0.87，95%CI 0.61 - 1.25）。
局限性
观察到的器官捐献同意率的增加如何转化为更多的器官供应尚不清楚。
结论
观看一段关于器官捐献的简短视频并被提示向初级保健提供者询问一个关于捐献的问题，导致了更多的器官捐献讨论并提高了器官捐献同意率。对临床就诊期间所花费时间的满意度未受影响。
试验注册
clinicaltrials.gov标识符：NCT01697137。
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