Protocol for the AKT-MP trial: Access to Kidney Transplantation in Minority Populations.
Protocol for the AKT-MP trial: Access to Kidney Transplantation in Minority Populations.
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DOI：
10.1016/j.conctc.2022.101015
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发表时间：
2022-12
影响因子：
1.5
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中科院分区：
文献类型：
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肾移植(KT)是治疗肾衰竭(KF)的最佳治疗方法，尽管完成KT评估是获得移植机会的关键步骤，但过程漫长、耗时和繁重。此外，尽管非西班牙裔白人的转诊率相似，但拉美裔/拉丁裔和美国印第安人都不太可能被列入等待名单或接受KT。少数民族人群获得肾脏移植(AKT-MP)试验比较了两种以患者为中心的方法，以促进KT评估：肾移植快速通道(KTFT)，一个简化的KT评估流程；以及同行导航员(PN)，一个纳入励志访谈的同行辅助评估计划。这项务实的随机试验将使用一种比较有效性的方法来评估KTFT或PN是否可以帮助患者克服移植登记的障碍。我们将随机将患者分配到这两种情况下。我们将跟踪参与者的医疗记录，并在他们首次评估诊所就诊之前进行调查，并在他们完成或停止评估后再次进行调查。我们的目标是(1)比较KTFT和PN，以评估肾移植(KT)相关结果和成本效益的改善；(2)检查每种方法如何影响文化/背景因素、KT担忧、KT知识和KT矛盾心理的变化；以及(3)为两种方法的广泛实施建立一个框架。这项试验的结果将为促进评估过程、改善患者护理和减少KT方面的差异提供关键信息。
Kidney transplant (KT) is the optimal treatment for kidney failure (KF), and although completion of KT evaluation is an essential step in gaining access to transplantation, the process is lengthy, time consuming, and burdensome. Furthermore, despite similar referral rates to non-Hispanic Whites, both Hispanic/Latinos and American Indians are less likely to be wait-listed or to undergo KT. The Access to Kidney Transplantation in Minority Populations (AKT-MP) Trial compares two patient-centered methods to facilitate KT evaluation: kidney transplant fast track (KTFT), a streamlined KT evaluation process; and peer navigators (PN), a peer-assisted evaluation program that incorporates motivational interviewing. This pragmatic randomized trial will use a comparative effectiveness approach to assess whether KTFT or PN can help patients overcome barriers to transplant listing. We will randomly assign patients to the two conditions. We will track participants’ medical records and conduct surveys prior to their initial evaluation clinic visit and again after they complete or discontinue evaluation. Our aims are to (1) compare KTFT and PN to assess improvements in kidney transplant (KT) related outcomes and cost effectiveness; (2) examine how each approach effects changes in cultural/contextual factors, KT concerns, KT knowledge, and KT ambivalence; and (3) develop a framework for widespread implementation of either approach. The results of this trial will provide key information for facilitating the evaluation process, improving patient care, and decreasing disparities in KT.