Technological Innovations for Live Kidney Donor Follow-up Care Management

活体肾脏捐赠者后续护理管理的技术创新

• 批准号: 9371609
• 负责人: Macey Leigh Levan
• 金额: $ 15.81万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-15 至 2022-07-14
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9371609
• 关键词: Address; Adoption; Altruism; Attitude; Behavior; Benchmarking; Car Phone; Caring; Chronic Kidney Failure; Clinical; Communication; Communities; Comorbidity; Creatinine; Data; Detection; Development; Diabetes Mellitus; Dialysis procedure; Doctor of Philosophy; Early Diagnosis; Early Intervention; Education; Electronic Mail; Elements; Employee Strikes; End stage renal failure; Failure; Focus Groups; Foundations; Funding; Future; Glomerulonephritis; Goals; Health; Health Policy; Health Technology; Health system; Hematuria; Hyperglycemia; Hypertension; Individual; Intervention; Intervention Trial; Interview; Kidney; Kidney Diseases; Kidney Transplantation; Knowledge; Laboratories; Lead; Maintenance; Medical; Mentored Research Scientist Development Award; Nephrectomy; Operative Surgical Procedures; Outcome; Ownership; Participant; Patients; Perception; Pilot Projects; Policies; Prevention strategy; Proteins; Proteinuria; Provider; Qualitative Methods; Randomized Controlled Trials; Recruitment Activity; Research; Research Design; Risk; Serum; Surveys; System; Technology; Testing; Text; Time; Training; Transplantation; Urine; Work; base; career; cost; design; epidemiology study; experience; faculty research; follow-up; improved; informant; innovation; mHealth; medical schools; novel; patient oriented; patient oriented research; preference; risk minimization; satisfaction; technological innovation; therapy development; tool

Project Summary Dr. Macey L. Henderson, JD, PhD, is research faculty in the Department of Surgery at Johns Hopkins School of Medicine. She seeks a Mentored Research Scientist Development Award in order to gain training and experience in patient-oriented research, qualitative methods, mHealth intervention development, and RCT design. Live donor kidney transplantation (KT) offers patients with end-stage renal disease (ESRD) timely treatment with superior outcomes to dialysis or deceased donor KT. But for the 6000+ live kidney donors (LKDs) yearly who make the sacrifice, and the 100,000+ living with one kidney, nephrectomy represents an elevated risk of kidney disease and other comorbidities. Dr. Henderson is a previous kidney donor and has dedicated her career to improving the lifelong donor experience. Currently, the most striking gap in the care of LKDs is the lack of regular medical follow-up. While hardly adequate for true care of LKDs (policy only requires follow-up to 24 months), implementation of even this rudimentary requirement has proven nearly impossible: LKDs between 2013-2015 still have only 68%, 62%, and 53% successful follow-up at 6, 12, and 24 months, with no further improvement since the policy requirement, even in the face of disciplinary action to centers who do not meet follow-up benchmarks: clearly transplant centers currently lack the tools to improve LKD engagement. Given the embarrassing failure of the current system of LKD follow-up, alternative approaches are of the utmost urgency for the medical community to uphold its obligation to care for these altruistic, at-risk individuals. Follow-up barriers cited by transplant centers, including administrative burden, cost, and lack of patient engagement, may be overcome by leveraging electronic communications and mobile health (mHealth) technologies which are convenient, low cost, and easily scalable. The aims of the project are: 1) to analyze preferences for and barriers to adoption of mHealth by LKDs and transplant providers, 2) to develop a functional mHealth system to support LKD follow-up and engagement, and 3) to pilot the mHealth system and design a future randomized control trial of this intervention. This proposal gives Dr. Henderson the training required to complete the proposed research. This knowledge can support the development of patient-oriented ESRD prevention strategies, promote health maintenance behaviors, and lay the foundation for a randomized controlled trial of our novel mHealth system. Our findings will address a critical knowledge gap in how follow-up and patient-engagement for LKDs can be improved. Conducting this study will expand Dr. Henderson's skillset to include patient-oriented research, qualitative methods, mHealth intervention development, and RCT design enabling her transition to independence.

项目总结