Abstract: TH-PO981

Effectiveness of iChoose Kidney Decision Aid on Kidney Transplant Knowledge

Session Information

Category: Transplantation

  • 1702 Transplantation: Clinical and Translational

Authors

  • Patzer, Rachel E., Emory University, Atlanta, Georgia, United States
  • McPherson, Laura J., Emory University, Atlanta, Georgia, United States
  • Basu, Mohua, None, Peachtree City, Georgia, United States
  • Mohan, Sumit, Columbia University, New York, New York, United States
  • Pastan, Stephen O., Emory University, Atlanta, Georgia, United States
Background

We developed a shared mobile decision aid (iChoose Kidney) that displays individualized risk estimates of survival and mortality for dialysis vs. kidney transplant for patients with end-stage renal disease (ESRD). We examined whether use of iChoose Kidney was associated with improved gains in transplant knowledge.

Methods

In a randomized controlled trial, 470 patients at 3 centers were randomized to receive education with (intervention) or without (standard of care) iChoose Kidney during their transplant evaluation. Patients completed surveys immediately before and after evaluation and gain in transplant knowledge (9 item scale) from pre- to post-evaluation was calculated by subtracting mean pre-survey from post-survey scores. Knowledge gains were assessed by study group and by race, health literacy and numeracy levels.

Results

Among 443 patients completing both surveys, mean age was 51 years, with 63% male, and 48% black. The mean pre- and post-evaluation transplant knowledge scores were 5.1 ± 2.1 and 5.8 ± 1.9, respectively, with a mean difference of 0.7 ± 1.7 points. Change in knowledge during the visit was significantly greater among iChoose (1.0 ± 1.8) vs. control (0.3 ± 1.4) for all patients (p<0.0001) (Figure 1) as well as for black (1.1 ± 1.7 vs. 0.4 ± 1.4; p=0.04) and white (1.5 ± 1.8 vs. 0.2 ± 1.9; p=0.003) patients. Intervention (vs. control) patients with moderate (1.2 ± 1.7 vs. 0.4 ± 1.1; p=0.02) and high (1.0 ± 1.8 vs. 0.2 ± 1.5; p=0.001) literacy and moderate (1.3 ± 1.9 vs. 0.2 ± 1.4; p=0.0001) and high numeracy (0.8 ± 1.4 vs. 0.2 ± 1.1; p=0.02) benefited most from the tool; while patients with low literacy (1.0 ± 1.9 vs. 0.7 ± 1.4; p=0.41) and low numeracy (1.0 ± 1.9 vs. 0.7 ± 1.6; p=0.39) had non-significant improvements.

Conclusion

The iChoose Kidney decision aid was effective in improving ESRD patient transplant knowledge among patients undergoing transplant evaluation. Similar shared decision aids could help clinicians better inform patients about transplant.

Funding

  • Private Foundation Support