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022 Shared decision making for kidney organ offer decisions using a kidney offer plan
  1. Kasey R Boehmer1,2,3,
  2. Carrie A Schinstock1,
  3. Maria Belen Mateo Chavez3,
  4. Christi Sagen3,
  5. Maddie O’Grady3,
  6. Angela Silvy3,
  7. Jordan Mcwilliams4,
  8. Warren Mckinney5,
  9. Allyson Hart5,
  10. Ian G Hargraves3,
  11. Mark Linzer4,
  12. Victor Montori3,
  13. Cory R Schaffhausen1
  1. 1Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
  2. 2Division of Health Care Delivery Research, Mayo Clinic, Rochester, MN, USA
  3. 3Knowledge and Evaluation Research (KER) Unit, Mayo Clinic, Rochester, MN, USA
  4. 4Hennepin Healthcare Research Institute (HHRI), Minneapolis, MN, USA
  5. 5Department of Medicine, Hennepin Healthcare (HHS), University of Minnesota (UMN), Minneapolis, MN, USA

Abstract

Introduction For kidney transplant candidates and their care team, deciding to accept a donor organ with known or potential limitations can be stressful and lead to declined offers. We expanded an online decision support tool to include a printable Kidney Offer Plan (KOP) to guide patients and clinicians in shared decision making. Information includes a summary of key facts (page 1) and a review of patient consent and other actions patients can take (page 2 and figure 1). We sought to field test the KOP to iteratively improve its usefulness and ready it for testing in a randomized trial.

Methods Transplant candidates were enrolled to participate in a shared decision-making discussion with a transplant coordinator. Enrolled patients gained access to the online decision support tool before the discussion. During the discussion, the patient and transplant coordinator reviewed the KOP. Discussions were recorded with video or audio. We summarized observations from recordings to inform future iterations.

Results Five transplant candidates participated in the prototype evaluation phase. Each clinical visit lasted about 20–60 minutes. Two investigators reviewed participant recordings. Initial findings indicate patients and providers followed prompts in the KOP and reviewed consent decision, potential donor risks, and actions to prepare for an offer.

Discussion New shared decision-making tools for offer decisions may address gaps in patient counseling, particularly after waitlist evaluations.

Conclusion Prototype testing of the Kidney Offer Plan supports ongoing iteration of this intervention in preparation for its evaluation in a randomized trial.

Abstract 022 Figure 1

Portion of page 2 of the kidney offer plan to review consent decisions

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